Long-term care preferences of hospitalized persons with AIDS

J Gen Intern Med. Nov-Dec 1991;6(6):524-8. doi: 10.1007/BF02598221.

Abstract

Objective: To determine in a cohort of hospitalized persons with AIDS: 1) their preferences for various postdischarge long-term care settings, 2) the postdischarge settings recommended by primary care providers (doctors, nurses, and social workers), and 3) the impact of these views on the resulting discharge dispositions.

Design: Prospective cohort study.

Setting: Medical wards of five Seattle tertiary care hospitals.

Participants: 120 consecutive hospitalized persons with AIDS and their primary care providers.

Measurements and main results: Although 70 (58%) of the patients found care in an AIDS long-term care facility acceptable, 87 (73%) preferred home care. Thirty-eight (32%) of the cohort were appropriate for long-term care after hospitalization, according to primary care providers. Eleven of the 38 patients deemed appropriate for long-term care were discharged to long-term care settings; among these, three had preferred home care. Likelihood of discharge to long-term care settings increased if patients found it acceptable (OR = 7.1; 95% CI = 3.2, 15.5), if they did not prefer home care (OR = 7.7; 95% CI = 4.7, 13.5), and if providers judged them to be appropriate for long-term care (OR = 29; 95% CI = 13, 64). In unstructured interviews, availability of emotional and medical support and privacy emerged as important factors to persons with AIDS considering long-term care.

Conclusions: Hospitalized persons with AIDS willingly express their desires for various postdischarge care settings. A majority find long-term care in AIDS facilities acceptable, although they generally prefer home care. Discharge disposition is associated with acceptability, preference, and appropriateness for long-term care.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Acquired Immunodeficiency Syndrome / epidemiology
  • Acquired Immunodeficiency Syndrome / nursing
  • Acquired Immunodeficiency Syndrome / psychology*
  • Adult
  • Attitude of Health Personnel
  • Attitude to Health
  • Cohort Studies
  • Home Nursing
  • Humans
  • Long-Term Care*
  • Patient Acceptance of Health Care*
  • Patient Discharge*
  • Patient Participation*