Home-Based Care Provider Perspectives on Care Refusal During the COVID-19 Pandemic.
Jennifer B Inloes, Allyson Brown, Zoe Rettell and 2 others
PMID 36594910WHAT IT FOUND
Home health providers said older patients refused nurses and therapists because they feared catching COVID-19 from them.
Providers described hospitalizations from missed wound, medication, drain, and post-operative care, and felt unprepared to calm patients.
Key findings
01Providers said patients refused home-based care because they feared catching COVID-19 from nurses and therapists, even when providers followed infection-control precautions.
02Providers described patients ending up in hospital after refusing home care for wounds, medication management, drains, or post-operative teaching.
03Providers felt unprepared to manage patients' fear of death and struggled to counter conflicting information from media, family, and changing guidance.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study included 27 providers from 8 urban counties, so it cannot represent all home-based care providers or patients. Rural counties were not assessed. Most participants were Asian or White and female, so Black, Latinx, and male provider perspectives were missing. The findings are providers' perceptions, not patients' own accounts or measured clinical outcomes. Qualitative interviews cannot establish how common care refusal was or prove that refusal caused hospitalisation. Recruitment response was low because agencies were contacted during an active pandemic.
The easy way to misread this
Do not conclude that infection-control education or provider reassurance prevents care refusal or improves outcomes. The study reports providers' perceptions and cannot show that any strategy worked, and the participants were providers, not patients.