Background: Since the Patient Protection and Affordable Care Act law of 2010, hospitals are held accountable by payers for readmissions. Family caregiving is an essential, yet understudied, factor that can hasten, delay, or prevent hospital readmissions. The purpose of this study was to describe what actions family caregivers of persons with stroke take to prevent readmissions, and if actions are taken, the reasons for those actions.
Methods: Guided by Friedemann’s framework, this study used a qualitative descriptive design. A one-time structured interview was conducted to explore actions taken by family caregivers to prevent hospital readmissions for care recipients with stroke, and reasons for these actions. Participants were adult family caregivers from one Ohio city who had been providing care for at least six months after initial hospitalization. Data were analyzed using Colaizzi’s content analysis and Friedemann’s framework was applied to the emerging themes.
Results: Caregivers (n=13) indicated actions that encompassed five themes: 1) Enhancing physical health with day-to-day interventions (system maintenance and individuation in Friedemann’s terms), 2) Providing mental and emotional support within the dyad (coherence), 3) Pursuing healthy relationships with others through community involvement (coherence), 4) Utilizing services within the healthcare system (system maintenance), 5) Thinking ahead and making the environment safe (system maintenance and individuation). Reasons underlying caregiver actions were related to four themes: 1) Fearing other health problems will occur if no action is taken (system maintenance), 2) Believing actions will improve or prevent health problems (individuation and system maintenance), 3) Adjusting to challenges based on past experiences (individuation and system change), 4) Recognizing a history together and a commitment to each other (coherence and system maintenance).
Conclusion: Understanding actions stroke family caregivers take, and the underlying reasons for those actions, enables healthcare providers to deliver targeted education and suggest community resources to potentially prevent hospital readmissions.