Abstract
Patients’ and carers’ views regarding the Portuguese model of home respiratory care were recently described, yet the complementary perspective of healthcare professionals (HCPs) is still to be investigated. Thus, this study explored HCPs experience in the management of patients needing home respiratory therapies (HRT), and their perspective about the Portuguese model. A phenomenological descriptive study, using focus groups, was carried out with 28 HCPs (median 42 y, 68% female) with distinct backgrounds (57% pulmonologists, 29% clinical physiologists, 7% physiotherapists, 7% nurses). Three focus groups were conducted in three regions of Portugal. Thematic analysis was performed by two independent researchers. HCPs have in general a positive view about the organization of the Portuguese model of home respiratory care, which was revealed in four major topics: Prescription (number of references, n = 171), Implementation and maintenance (n = 162), Carer involvement (n = 65) and Quality of healthcare (n = 247). Improvements needed were related to patients’ late referral, HRT prescription (usability of the medical electronic prescription system and renewals burden), patients’ education, access to hospital care team, lack of multidisciplinary work and articulation between hospital, primary and home care teams. This study describes the perspective of HCPs about the Portuguese model of home respiratory care and identifies specific points where improvements and reflections are needed. This knowledge may be useful to decision makers improve the current healthcare model.
Highlights
Home respiratory therapies (HRT), such as long-term oxygen therapy and home mechanical ventilation, are prescribed to improve the health-related quality of life of patients with respiratory disorders such as chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, cystic fibrosis, bronchiectasis, neuromuscular diseases, among others.home respiratory therapies (HRT) are one of the most important home healthcare services [1] and patients needing HRT are increasing [2]
“( . . . ) we demonstrate the device, we test which interface is best suited to the patient and, more importantly, we talk about the therapy” (Male, Clinical physiologist, 29 y)
Our study aimed to explore healthcare professionals (HCPs)’s perspective about the organization of the model of home respiratory care
Summary
HRT are one of the most important home healthcare services [1] and patients needing HRT are increasing [2]. This adds to HRT high complexity, characterized by the chronicity of the patient condition itself, the need of patients’ and carers’ training and the involvement of variety of healthcare professionals [3,4]. This scenario poses significant challenges to the capacity of health care services worldwide. A necessary step in the process of maintaining and improving quality is to monitor and evaluate the quality of healthcare in routine clinical practice [2]
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