title: Elderly patients' participation in emergency medical services when offered an alternative care pathway.
abstract: As organizational changes in the healthcare system are in progress, to enhance care quality and reduce costs, it is important to investigate how these changes affect elderly patients' experiences and their rights to participate in the choice of healthcare. The aim of this study is to describe elderly patients' lived experience of participating in the choice of healthcare when being offered an alternative care pathway by the emergency medical services, when the individual patient's medical needs made this choice possible. This study was carried out from the perspective of caring science, and a phenomenological approach was applied, where data were analysed for meaning. Data consist of 11 semi-structured interviews with elderly patients who chose a healthcare pathway to a community-based hospital when they were offered an alternative level of healthcare. The findings show that the essence of the phenomenon is described as "There was a ray of hope about a caring encounter and about being treated like a unique human being". Five meaningful constituents emerged in the descriptions: endurable waiting, speedy transference, a concerned encounter, trust in competence, and a choice based on memories of suffering from care. The conclusion is that patient participation in the choice of a healthcare alternative instead of the emergency department is an opportunity of avoiding suffering from care and being objectified.
authors: Section of Emergency Medicine, Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden.
authors: Veronica
authors: V
authors: Vicente
authors: Maaret
authors: M
authors: Castren
authors: Fredrik
authors: F
authors: Sjöstrand
authors: Birgitta Wireklint
authors: BW
authors: Sundström
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002755:Choice Behavior; D003153:Community Health Services / Q000458:organization & administration* / Q000592:standards; D003695:Delivery of Health Care / Q000592:standards*; D004632:Emergency Medical Services / Q000458:organization & administration* / Q000592:standards; D005260:Female; D006299:Health Services for the Aged / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D008297:Male; D010358:Patient Participation / Q000523:psychology*; D017060:Patient Satisfaction; D011361:Professional Competence; D011795:Surveys and Questionnaires; D013548:Sweden
keywords: Caring; caring encounter; choice of healthcare; community-based hospital; geriatric; lifeworld; lived experiences; patient participation; suffering from care