Self-management after hospitalisation

Abstract

Aims and objectives: The aim of this research was to explore the processes used by older individuals to self-manage their health during the first 30 days after being discharged from the hospital. The underlying philosophy for this research was symbolic interactionism. From this perspective, individuals make meaning out of their experiences and act on the basis of those meanings. Background: Little is known about the processes older adults use to adjust to and self-manage their evolved health status after returning home from the hospital. Few studies have explored this period from the perspective of the older individual living in the situation. Methods: We used case study method to develop a collective, instrumental case to explain the phenomena of older individuals self-managing their health after hospitalisation. Data included interviews, participant diaries and researcher field notes. Results: The sample included three women who were at least 75 years old, had been hospitalised for at least 24 hr and had been discharged within the week prior to the first interview. Data from the participants were used to create a composite case, Mrs. C. She managed her autonomy, activity, attitude, health and relationships across three phases of posthospitalisation, returning home, adjusting and the evolved normal. Conclusions: This study provides insight into the experience of older individuals during the first 30 days after a stay in a healthcare facility and supports previous research findings regarding hospitalisation and self-management of chronic health problems. Implications for practice: The findings provide evidence that returning home is a process that usually takes about a month to get into a new routine. Nurses can use this case study to describe some people’s experience after discharge, and to help the older individual to identify friends and family who can provide physical and emotional support during the time immediately after discharge.