Older surgical patients’ preferences for follow-up care after hospital discharge: A multi-method qualitative study into their underlying needs

Background: Almost 30 % of older patients suffer from functional decline during hospital stay which often makes follow-up care decisions necessary. However, little is known about the topics that are relevant to these patients and their families to address in discharge conversations. Objective: This study aims to provide insight into the perspective of older surgical patients on follow-up care by exploring their considerations expressed throughout the process of discharge planning. Design: A multi-method qualitative study Participants: Participants were older patients from a surgical ward who anticipated to require follow-up care after discharge. Methods: Data collection included: 1) interviews with patients; 2) informal conversations with family members and professionals; 3) non-participant observations during medical rounds and bedside conversations; 4) extraction from medical records. In all data sources, the focus was on capturing the patients’ considerations with regard to follow-up care. We employed inductive thematic analysis to identify needs that underlie patients’ preferences for follow-up care. Results: Twelve older surgical patients with complex or delayed discharge were followed. Their considerations with regard to follow-up care revealed five underlying needs: 1. Safety (adequate care), 2. Familiarity (trusted people and surrounding), 3. Independence (active and autonomous living), 4. Continuity (resume previous life) and 5. Relief (ending endurance). Most participants had more than one need. Conclusions: Older surgical patients’ perspective on follow-up care can be captured by five underlying needs. Gaining insight into these needs contributes to a better understanding of patients’ preferences for follow-up care. We therefore recommend exploring these needs in older surgical patients, as well as identifying potential similar or additional needs for other subgroups of older hospital patients, as an important step toward personalized decision-making in transitional care.