BACKGROUND: Due to the rapid ageing of the population, there is increasing demand for long-term care in the people's home environment. Such care aims to allow the people to stay at home and avoid hospitalisation or other institutional care. In home health care, care must be provided at the highest possible quality, with the focus on the people's needs and experiences. OBJECTIVES: This study explores the experiences and needs of frail older people receiving home health care. DESIGN AND METHODS: An exploratory descriptive qualitative approach was chosen. Audio-taped semi-structured interviews were conducted with fifteen older people receiving home health care. A content analysis was used to analyse the data collected. RESULTS: The content analysis identified one main theme, three categories and seven subcategories related to frail older people's needs and experiences of home health care. The main theme was quality of care. The first category, Safe and Secure Care, consisted of three subcategories: Education and Experience of Nurses, Information, and Continuity of Care in terms of personnel continuity and regular care. The second category, Autonomy, contained two subcategories: Decision-making and Self-sufficiency. The last category, Relationship with Professionals, consisted of two subcategories: Personality of Nurse and Partnerships. CONCLUSION: Older people are able to express their satisfaction or dissatisfaction with home health care. The results of this study revealed that the quality of care is crucial for frail older people. IMPLICATION FOR PRACTICE: The provision of home health care is inherently highly specific; home care nurses should work to provide the highest possible quality of care. In particular, nurses should focus on ensuring that the care they provide is safe, effective, timely, efficient and person-centred.

Department of Longevity Studies Faculty of Humanities Charles University Prague Czech Republic

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Bagchus, C. , Dedding, C. , & Bunders, J. F. G. (2015). ’I’m happy that I can still walk’—Participation of the elderly in home care as a specific group with specific needs and wishes. Health Expectations, 18(6), 2183–2191. 10.1111/hex.12188 PubMed DOI PMC

Breitholtz, A. , Snellman, I. , & Fagerberg, I. (2013a). Living with Uncertainty: Older Persons’ Lived Experience of Making Independent Decisions over Time. Nursing Research and Practice, 2013, 1–8. 10.1155/2013/403717 PubMed DOI PMC

Breitholtz, A. , Snellman, I. , & Fagerberg, I. (2013b). Older people’s dependence on caregivers’ help in their own homes and their lived experiences of their opportunity to make independent decisions. International Journal of Older People Nursing, 8(2), 139–148. 10.1111/j.1748-3743.2012.00338.x PubMed DOI

Cambridge Dictionary (2020). PROFESSIONAL | definition in the Cambridge English Dictionary. https://dictionary.cambridge.org/us/dictionary/english/professional

Campbell, S. , Greenwood, M. , Prior, S. , Shearer, T. , Walkem, K. , Young, S. , Bywaters, D. , & Walker, K. (2020). Purposive sampling: Complex or simple? Research case examples. Journal of Research in Nursing, 25(8), 652–661. 10.1177/1744987120927206 PubMed DOI PMC

Campbell, S. M. , Roland, M. O. , & Buetow, S. A. (2000). Defining quality of care. Social Science & Medicine, 51(11), 1611–1625. 10.1016/S0277-9536(00)00057-5 PubMed DOI

Clegg, A. , Young, J. , Iliffe, S. , Rikkert, M. O. , & Rockwood, K. (2013). Frailty in elderly people. Lancet, 381(9868), 752–762. 10.1016/S0140-6736(12)62167-9 PubMed DOI PMC

Cohen‐Mansfield, J. , Sela, A. H. , Iecovich, E. , & Golander, H. (2017). Quality of care for frail older persons in a homecare setting: What is it and how can it be measured? International Psychogeriatrics, 30(9), 1259–1267. 10.1017/S1041610217002228 PubMed DOI

Dostálová, V. , Bártová, A. , Bláhová, H. , & Holmerová, I. (2020). The needs of older people receiving home care: A scoping review. Aging Clinical and Experimental Research, 33(3), 495–504. 10.1007/s40520-020-01505-3 PubMed DOI

Downe‐Wamboldt, B. (1992). Content analysis: Method, applications, and issues. Health Care for Women International, 13(3), 313–321. 10.1080/07399339209516006 PubMed DOI

Duan, C. , & Hill, C. E. (1996). The current state of empathy research. Journal of Counseling Psychology, 43(3), 261–274. 10.1037/0022-0167.43.3.261 DOI

Duke, M. , & Street, A. (2005). Tensions and constraints for nurses in hospital‐in‐the‐home programmes. International Journal of Nursing Practice, 11(5), 221–227. 10.1111/j.1440-172X.2005.00527.x PubMed DOI

European Parliament (2005). Directive 2005/36/EC. Retrieved from https://eur‐lex.europa.eu/legal‐content/EN/TXT/?uri=celex%3A32005L0036

Eurostat (2018). 1 in 5 households in need in the EU use professional homecare services. Retrieved from Eurostat website: https://ec.europa.eu/eurostat/web/products‐eurostat‐news/‐/DDN‐20180228‐1

Freeman, G. K. , Olesen, F. , & Hjortdahl, P. (2003). Continuity of care: An essential element of modern general practice? Family Practice, 20(6), 623–627. 10.1093/fampra/cmg601 PubMed DOI

From, I. , Johansson, I. , & Athlin, E. (2009). The meaning of good and bad care in the community care: Older people’s lived experiences. International Journal of Older People Nursing, 4(3), 156–165. 10.1111/j.1748-3743.2008.00156.x PubMed DOI

Graneheim, U. H. , Lindgren, B.‐M. , & Lundman, B. (2017). Methodological challenges in qualitative content analysis: A discussion paper. Nurse Education Today, 56, 29–34. 10.1016/j.nedt.2017.06.002 PubMed DOI

Graneheim, U. H. , & Lundman, B. (2004). Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24(2), 105–112. 10.1016/j.nedt.2003.10.001 PubMed DOI

Grove, S. K. , Burns, N. , & Gray, J. (2013). The practice of nursing research: Appraisal, synthesis, and generation of evidence (7th edn). Elsevier/Saunders.

Henderson, V. (2006). The concept of nursing*. Journal of Advanced Nursing, 53(1), 21–31. 10.1111/j.1365-2648.2006.03660.x PubMed DOI

Hill, K. M. , Twiddy, M. , Hewison, J. , & House, A. O. (2014). Measuring patient‐perceived continuity of care for patients with long‐term conditions in primary care. BMC Family Practice, 15, 191. 10.1186/s12875-014-0191-8 PubMed DOI PMC

Holly, C. , Bugel, M. J. , Scuderi, D. , Estrada, R. P. , Harvey, J. , Echevarria, M. , & Singer, A. (2014). Scholarly Inquiry and the DNP Capstone. Springer Publishing Company. https://connect.springerpub.com/content/book/978‐0‐8261‐9388‐9

Holmerová, I. (2014). Dlouhodobá péče: Geriatrické aspekty a kvalita péče. Grada Publishing a.s.

Holmerová, I. (2018). Case management v péči o lidi žijící s demencí: Koordinace péče zaměřená na člověka. Fakulta humanitních studií Univerzity Karlovy.

Howell, E. A. , & Zeitlin, J. (2017). Quality of Care and Disparities in Obstetrics. Obstetrics and Gynecology Clinics of North America, 44(1), 13–25. 10.1016/j.ogc.2016.10.002 PubMed DOI PMC

Institute of Medicine (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. National Academies Press (US). http://www.ncbi.nlm.nih.gov/books/NBK222274/ PubMed

Jarling, A. , Rydström, I. , Ernsth‐Bravell, M. , Nyström, M. , & Dalheim‐Englund, A.‐C. (2018). Becoming a guest in your own home: Home care in Sweden from the perspective of older people with multimorbidities. International Journal of Older People Nursing, 13(3), e12194. 10.1111/opn.12194 PubMed DOI

Liveng, A. (2011). The vulnerable elderly’s need for recognizing relationships—A challenge to Danish home‐based care. Journal of Social Work Practice, 25(3), 271–283. 10.1080/02650533.2011.597173 DOI

Mahoney, F. I. , & Barthel, D. W. (1965). Functional evaluation: The Barthel Index. Maryland State Medical Journal, 14, 61–65. PubMed

McCabe, C. (2004). Nurse‐patient communication: An exploration of patients’ experiences. Journal of Clinical Nursing, 13(1), 41–49. 10.1111/j.1365-2702.2004.00817.x PubMed DOI

McGarry, J. (2010). Relationships between nurses and older people within the home: Exploring the boundaries of care. International Journal of Older People Nursing, 5(4), 265–273. 10.1111/j.1748-3743.2009.00192.x PubMed DOI

Ministry of Health, CR (2021). Act No. 96/2004 Coll. The Act on Non‐Medical Health Professions. Retrieved from Zákony pro lidi website https://www.zakonyprolidi.cz/cs/2004‐96

Moe, A. , Hellzen, O. , & Enmarker, I. (2013). The meaning of receiving help from home nursing care. Nursing Ethics, 20(7), 737–747. 10.1177/0969733013478959 PubMed DOI

Phillippi, J. , & Lauderdale, J. (2018). A Guide to Field Notes for Qualitative Research: Context and Conversation. Qualitative Health Research, 28(3), 381–388. 10.1177/1049732317697102 PubMed DOI

Randström, K. B. , Asplund, K. , Svedlund, M. , & Paulson, M. (2013). Activity and participation in home rehabilitation: Older people’s and family members’ perspectives. Journal of Rehabilitation Medicine, 45(2), 211–216. 10.2340/16501977-1085 PubMed DOI

Richardson, K. , Macleod, R. , & Kent, B. (2012). A Steinian approach to an empathic understanding of hope among patients and clinicians in the culture of palliative care. Journal of Advanced Nursing, 68(3), 686–694. 10.1111/j.1365-2648.2011.05793.x PubMed DOI

Samuelsson, G. , & Wister, A. (2000). Client expectations and satisfaction of quality in home care services. A Consumer Perspective. Home Care Provider, 5(6), 223–230. 10.1067/mhc.2000.111864 PubMed DOI

Shirley, E. D. , & Sanders, J. O. (2016). Measuring Quality of Care with Patient Satisfaction Scores. The Journal of Bone and Joint Surgery. American, 98(19), e83. 10.2106/JBJS.15.01216 PubMed DOI

Strandås, M. , & Bondas, T. (2018). The nurse‐patient relationship as a story of health enhancement in community care: A meta‐ethnography. Journal of Advanced Nursing, 74(1), 11–22. 10.1111/jan.13389 PubMed DOI

Sundler, A. J. , Eide, H. , van Dulmen, S. , & Holmström, I. K. (2016). Communicative challenges in the home care of older persons—A qualitative exploration. Journal of Advanced Nursing, 72(10), 2435–2444. 10.1111/jan.12996 PubMed DOI

Tong, A. , Sainsbury, P. , & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32‐item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349–357. 10.1093/intqhc/mzm042 PubMed DOI

Vahdat, S. , Hamzehgardeshi, L. , Hessam, S. , & Hamzehgardeshi, Z. (2014). Patient involvement in health care decision making: A review. Iranian Red Crescent Medical Journal, 16(1), e12454. 10.5812/ircmj.12454 PubMed DOI PMC

Vaismoradi, M. , Turunen, H. , & Bondas, T. (2013). Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study. Nursing & Health Sciences, 15(3), 398–405. 10.1111/nhs.12048 PubMed DOI

Wan, Q. , Jiang, L. , Zeng, Y. , & Wu, X. (2019). A big‐five personality model‐based study of empathy behaviors in clinical nurses. Nurse Education in Practice, 38, 66–71. 10.1016/j.nepr.2019.06.005 PubMed DOI

WHO (2020a). Ageing and life course. Retrieved from WHO website: http://www.who.int/ageing/en/

WHO (2020b). Quality of care. Retrieved from WHO website: https://www.who.int/health‐topics/quality‐of‐care#tab=tab_1

WHO Study Group on Home‐Based Long‐Term Care (Ed.). (2000). Home‐based long‐term care: Report of a WHO Study Group. World Health Organization. PubMed

Williamson, K. M. (2007). Home health care nurses’ perceptions of empowerment. Journal of Community Health Nursing, 24(3), 133–153. 10.1080/07370010701429512 PubMed DOI