Exploring How Gerontological Nursing Telephone Support Can Assist Informal Caregivers of Older Adults at Hospital Discharge-A Qualitative Study.

Abstract

To explore how receiving gerontological nurse telephone support assisted caregivers of older adults to provide care after hospital discharge. Informal caregivers are vital to the recovery of older patients after hospital discharge, but often feel under-prepared and unsupported. The need to strengthen caregiver support is becoming increasingly important due to the growing population of older adults and their needs for hospital services. This secondary analysis of a randomized controlled trial examined how nurse telephone support assisted caregivers in their caring role at the time of hospital discharge. A qualitative descriptive study. A purposive sample of informal caregivers (n = 47) who had received nurse telephone support was recruited. In-depth semi-structured interviews were conducted with participants at six (March 21-January 23) and 12 months (August 2021-June 2023) after the older adult's discharge. The nurses used a problem-solving approach to provide support. Transcripts were analysed inductively using content narrative analysis. Two themes emerged: (i) mastery and skills to care; (ii) empowerment to care. Caregiver mastery was developed through nurses providing tailored support that assisted caregivers to develop a structured approach to problem-solving, apply problem-solving to their personal circumstances, increase capacity and skills, and manage workload more effectively. Empowerment resulted from nurses creating a nurturing environment where caregivers developed a positive inner dialogue, increased confidence and capacity to foster a positive relationship with the care recipient and valued themselves. Synthesizing these themes via a concept map explained how nurse support assisted caregivers of older adults become more prepared to care and increase self-efficacy. Nurse telephone support can facilitate caregivers of older adults discharged from hospital to undertake problem-solving that is effective for their individual circumstances and empower them to care. Telephone calls enabled nurses to provide timely, tailored support for caregivers of older adults after hospital discharge. Nurses can provide expert, professional guidance via telephone to support caregivers be more prepared to care when older adults are discharged from hospital. This support should extend beyond instructions related to the care recipients' immediate needs and include the provision of knowledge and coaching to support a structured approach to problem-solving. Allocating dedicated time for hospital nurses to deliver caregiver support should be considered an integral component of person-centred care. This research strengthens the evidence for the valuable contribution that nurses can make to improving hospital discharge services. This study was reported using the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. The research team includes consumer investigator (HL) who provided input throughout the research, including design, procedures, data analysis and manuscript authorship. Australian New Zealand Clinical Trials Registry Identifier: ACTRN12620000060943.