The Essence of Home: An ethnography of the home and its meaning in the context of extended hospital stays in a pandemic

The patient experience of extended hospital stays and how these impact the relationship with home is under-researched. Understanding of these experiences may demonstrate how clinical communication affects patients and then inform clinical practice. This thesis uses the stories of patients and clinicians living in the Highlands and Islands of Scotland to explore these experiences during the Coronavirus pandemic. Informed by an autoethnographic approach, it aims to:<br/>[1] Explore the lived experience of how extended hospital stays have affected the relationship patients have with home in the context of the pandemic<br/>[2] Investigate how the communication culture of health and social care can impact this relationship<br/>[3] Assess how technology can/does affect relationships with home in relation to wellbeing in the context of health<br/>In-depth interviews with a cohort of patients (n=11) and clinical/health professionals (n=14) were conducted. The interviews explored the lived experience of participants and probed areas of the patient journey which are currently overlooked. These discussions were then analysed via reflexive thematic analysis, with the two participants cohorts analysed separately and then combined. Alongside the thematic analysis, creative tools such as vignettes and infographics have been utilised to richly report the stories told.<br/>This thesis uncovers the diversity of ways that the experience of extended hospital stays can distinctly influence the relationship with home and the process of being discharged, for example, how expectations affect the experience of home, and the role of material culture. This research unveils both the positive and negative impacts of communication culture within healthcare teams and beyond, including the influence of hierarchy, integrated working, and discharge communication. It reports the current perspectives on the role of technology in the context of hospital and home, for example, the future role of video conferencing or at home technological devices. By focusing on the discharge process, it concludes that discharge can be beneficially viewed as a transition, and how such journeys home have been experienced during the pandemic. This thesis uses storytelling to make voices heard; voices which could positively influence the experiences of others in the future.<br/>Included are a series of recommendations to improve staff and patient experience, including training strategies for students and seasoned clinicians, and tools to better communicate discharge and improve patient experience.

Name dc:type.qualificationname

Doctor of Philosophy (awarded by UHI)

Level dc:type.qualificationlevel

Doctoral Thesis

Grantor dc:publisher.institution

University of the Highlands and Islands

Year dc:date.issued

2023

Author dc:creator

• Hughes, Karen Rees

Advisor dc:contributor.advisor

• Gorely, Trish

Language dc:language

eng

Identifier

oai:pure.atira.dk:studenttheses/c104e871-68cd-4351-adb4-7ea1c980a460

OAI identifier oai:identifier

oai:pure.atira.dk:studenttheses/c104e871-68cd-4351-adb4-7ea1c980a460