Toward a safe home: Experiencing the transition to an outpatient setting with home mechanical ventilation. A thematic analysis

Background: With the progress in medical options, the need for home mechanical ventilation increases. The transition from long-term ventilation in an institution to home mechanical ventilation in an outpatient setting is a difficult phase in terms of setting up the network of care, coordination of care for those with the ventilatory insufficiency and the financing.Aim: The study describes how patients with ventilatory insufficiency and family caregivers experience the transition from an institution to an ambulatory setting with invasive or non-invasive home mechanical ventilation.Methods: A qualitative research design with a social-constructivist approach was adopted using thematic analysis according to Braun and Clarke. We included seven German-speaking patients (= 18 years old) with ventilatory insufficiency and home mechanical ventilation (> 6 h/day) from the German part of Switzerland, with discharge from an institution to home, and five family caregivers who care for patients with the described criteria.Results: The institution was seen as a safe place. Affected persons and their family caregivers had to create a safe environment at home. Three themes were formed inductively: To gradually build trust with each other, to become experts as family caregivers, to align their own network with the new care needs.Conclusions: The transition home succeeds in the interplay of gaining trust, building expertise, and creating sustainable networks. Professionals can use this knowledge to provide targeted support to patients with home mechanical ventilation and their family caregivers.