Overwhelmed, uncertain, or calm: Lessons from patients with acute infections in the emergency department. A qualitative interview study.

Abstract

There is limited understanding of how patients with acute infections experience the emergency department (ED) and how this relates to key aspects of person-centred care (PCC). Furthermore, the fast-paced and demanding nature of the ED presents challenges to the delivery of PCC. This study aims to explore the experiences of adult patients with acute infections in the ED and use these to identify strategies to better support healthcare providers in delivering PCC in the ED. Qualitative in-depth interviews were performed with adult patients who presented to the ED with a (suspected) acute infection between March and May 2023 in an academic hospital in the Netherlands. Thematic content analysis was performed on the interview transcripts. Sixteen interviews were performed, and seven themes were identified: 1. Information and expectation management, 2. Person-centred communication and interactions, 3. Accessibility and coordination of care, 4. Decision-making and patient participation, 5. Timeliness of care, 6. ED context and comfort and 7. Emotional experience and coping. In the overarching theme 7, three patient typologies were identified, the 'uncertain and alone' participants, the 'overwhelmed' participants and the 'calm and unhurried' participants, all of whom would benefit from specific communication and care approaches. This study highlighted several key aspects of PCC in the ED for patients with acute infections. While patients reported some unique experiences to infectious diseases, many were similar to those reported by patients with other conditions in the ED, as described in the literature. Three patient typologies were identified within the theme: 'emotional experience and coping'. Recognizing patient typologies can provide care providers with a practical framework to quickly tailor their care and communication strategies, enhancing the delivery of PCC in acute settings.