Heart Failure and Acute Myocardial Infarction Patients' and Caregivers' Perceptions of Reasons for 30-Day Readmissions in the Community Hospital Setting

Abstract
Hospital readmissions are often attributed to failed transitions of care. A gap in the literature exists in understanding readmissions from the patients’ and caregivers’ perspectives, particularly in the community hospital setting. The purpose of this study was to describe the experience of 30-day readmissions in heart failure and myocardial infarction patients, their root causes, and ways to prevent them from the perspective of patients and their caregivers in a community hospital setting. A phenomenological qualitative study was conducted. Data were collected through semi-structured interviews guided by the Health Belief Model. Colaizzi’s seven-step method was used to analyze the data and describe the essential structures of the readmission phenomenon. Six key themes emerged: a need for symptom relief, unmet learning needs, failure to address the primary health concern during the index admission, a lack of patient adherence, challenging treatment regimens, and lack of caregiver inclusion. The Health Belief Model provided the theoretical foundation for exploring patient factors related to readmissions. Perceptions of cardiac patient and their caregivers on the reasons for readmission and the means to prevent them are relevant for shaping effective care transitions. Clinicians need to understand each patient’s context for self-care and tailor interventions accordingly.