Care of the chronic, non-acutely ill elderly person in acute hospitals in light of the biomedical science approach

Abstract

The purpose of this study was to investigate aspects and specific events of health care intervention techniques rendered to chronic, non-acutely ill elderly patients, (henceforth known as CNIE), while in an acute care hospital. The patients' own perceptions were sought to ascertain if the care given was patient-centred or more characteristic with the traditional biomedical science approach (BMS). This latter approach, according to many researchers, remains the primary mode of hospital health care intervention. The BMS approach is described by sociologists and others as a health care strategy that is overly cure oriented rather than care oriented. It is impersonal, objective, and dualistic - the very opposite of a patient-centred approach. Using a patientcentred care survey to carry out empirical research, I set out to ascertain, at a local level, the extent and degree a BMS approach existed within Thunder Bay's three acute care hospitals. The sample included 32 participants who were or remain heavy users of health services. These individuals were either waiting for placement or recently placed into another care facility. At the time of the interview, qualified participants were located either in one of three Thunder Bay acute care hospitals, a private nursing home, one of two city Homes for the Aged, or in their own home. All shared their perceptions of the care they received while in hospital. CNIE patient demographic characteristics - sex, age, marital status, length of present hospitalization, former occupation, mother tongue, hospital recently treated at and reason for hospitalization - were documented. Six care indices were embodied in the patient-centered survey. These included Communication, Education, Emotional Support, Patient Needs and Preferences, Consistency of Quality of Care and Physical Comfort. Descriptive statistics were used for analysis of the results. Based on the comments obtained from the CNIE population sample, findings suggest that, although present or former patients were satisfied overall with the care they received while in an acute care hospital, there are particular reported problems in different domains of the care rendered to them which are congruent with characteristics/aspects of the traditional biomedical science approach. Results also suggest that the need for a paradigm shift - from a solely objective, rational and impersonal approach (vis a vis a biomedical science orientation) to a more biopsychosocial-like approach, (a "revolution” in the Kuhnian sense of the term), may not be as monumental a task as some researchers would suggest. Recommendations for further research are made.