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Abstract
Objective
Optimizing care at home, or home health care (HHC), is necessary as the population of care-dependent older people receiving care at home steadily increases. The COVID-19 pandemic tested Swedish primary care professionals as they provided HHC for a population of very frail older homebound people, but a better understanding of what healthcare workers did to manage the crisis may be useful for the further development of HHC. In this study, we aimed to understand how HHC physicians solved the problems of providing home healthcare during the pandemic to learn lessons on how to improve future HHC.
Methods
This is a qualitative study of individual interviews with 11 primary care physicians working in HHC (8 women) from 7 primary care practices in Region Stockholm, Sweden. Interviews were conducted between 1 December 2020, and 11 March 2021. The data were analyzed using inductive thematic analysis.
Results
We generated an overarching theme in our analysis: Physicians focus on core tasks and professional values in response to crisis. This theme incorporated three underlying subthemes describing this response: physicians prioritize and resolve ethically challenging situations in new ways, cultivate the patient perspective, and build on existing teams.
Conclusion
This study indicates that a healthcare system that gives HHC physicians agency to focus on core tasks and professional values could promote person-centered care.
KEY POINTS
Optimizing care at home, or home health care (HHC), is necessary as the population of care-dependent older people receiving care at home steadily increases.
During the COVID-19 pandemic, HHC physicians in Stockholm were able work person-centred and focus on clinically relevant tasks.
A healthcare system that allows HHC physicians to focus on core tasks and professional values can promote person-centered care.
Strategies to promote quality HHC include supporting physician autonomy, building on existing teams, and promoting collaboration between primary care providers and other caregivers.
Acknowledgements
Caroline Kappelin, Aniko Vég, Lars L Gustafsson
Author contributions
The idea for this study arose from group discussions at the research group’s monthly meetings, where all co-authors participated. KSM applied for and obtained ethical approval and funding. CW, KH, MB, PBR, and KSM made substantial contributions to the study design. CW, KH, MB, PBR, KSM, and CK recruited the participants. CW, MB, KH, PBR, KSM, CK, and AV conducted interviews. CW, KH, and SM conducted the first steps of thematic analysis, and all authors were engaged in the discussion and definition of themes and write-up, as well as in reciprocal reading. CW led to the write-up of the methods and the analysis results. KSM led the write-up of the background and discussion, together with the MB. The manuscript has been revised by all the co-authors. All authors approved the final version of the manuscript and agreed to be accountable for all aspects of the work, ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Disclosure statement
No potential conflict of interest was reported by the author(s).