Lack of sensitivity to readmission: A grounded theory study for explaining the process of readmitting patients suffering from congestive heart failure

Background: Readmission due to congestive heart failure is a global problem during the recent decades; however, little is known about the process of readmission in these patients. Aim: To clarify the readmission process of patients suffering from congestive heart failure in two large referral hospitals in Tehran, Iran. Method: A grounded theory approach was utilized. 42 experienced patients, families, nurses and cardiologists participated in the study. Data analysis was carried out over a period of 12 months (November 2007 to November 2008). Results: The main concern of participants was “managing the acute problems” of disease. The process of readmission begins with “concentrating on the concern”. So, all the participants neglected the patient readmission. Having managed the acute problems, the patients were discharged without a “comprehensive context oriented discharge planning” leading to their return to community without preparation or supporting system. This results in “traditional self-treatment” owing to unhealthy behaviors which brings about the readmission of patients. Neglecting or “lack of sensitivity to readmission” was presented as the core variable. Conclusion: In order to control readmission, we recommend those in charge of policy-making for public health to pay particular attention to this variable and taking step such as sensitizing people concerned.