Patient Experiences, Emotions and Reasons for Frequently using Emergency Health Care for Long-Term Conditions: A Qualitative Study

Abstract

1.1.Background:Chronic illness is associated with increased health service utilisation including frequent use of the emergency department (ED). 1.2.Objectives: In a qualitative study, we aimed to address the reasons for which patients with long-term conditions (LTCs) seek frequently urgent or unscheduled care in the ED. 1.3.Methods:Semi-structured interviews were conducted with 35 patients with diabetes, COPD, and rheumatological disorders attending the ED (23 frequent and 12 non-frequent users). Themes concerning the meaning attributed to the symptom, previous ED experiences and expectations, emotional state, emotional responses during the ED visit, illness perceptions, and accessibility to ED and health care servicessatisfaction were examined. Analysis was carried out using content analysis method. 1.4.Results:Previous negative ED experiences and associated emotions were mainly the case for frequent users; frustration of the patient’s needs, devaluation of the patient’s urgent condition and inadequate information provision were underlying their accounts. Elements of poor clinical communication between the patient and the healthcare providers appeared to mediate the emotional state and whole quality of the service provided only for frequent users, especially for those who reported exhaustion related to the chronicity of the illness. 1.5.Conclusion:Frequent ED use by people with LTCs seems to be associated with negative emotions and unmet patients’ needs to experience a trustful environment and feel safe about his health condition. Improving the clinical communication between the patient and the healthcare providers in the ED and fulfilling the patients’ emotional unmet needs may prove effective in reducing urgent healthcare use by people with LTCs.