Hospital-based home care for people with severe mental illness in Taiwan: a substantive grounded theory

The purpose of this study is to generate a substantive theory of hospital-based home care for people with severe mental illness in Taiwan.

Despite the documented advantages of hospital-based home care services, there is a lack of information and understanding regarding the practices, functions and limitations. Currently, there is no model for how those services are to be provided and what factors will affect these services.

The grounded theory method of Strauss and Corbin (Basics of Qualitative Research: Grounded Theory Procedures and Techniques, SAGE Publications, 1990) was used to develop a substantive theory through a paradigm model, including causal conditions, context, intervening conditions, action/interaction strategies and consequences.

This study was conducted in six different hospital areas in Central Taiwan in 2007-2008. Data were collected using semi-structured face-to-face interviews. Constant comparative analysis continued during the open, axial and selective coding process until data saturation occurred. Participants were selected by theoretical sampling. When theoretical saturation was achieved, 21 clients with mental illness, 19 carers and 25 professionals were interviewed.

A substantive theory of hospital-based home care for people with severe mental illness in Taiwan was developed. The core category was the process of hospital-based home care in helping people with severe mental illness, with 15 categories and 33 sub-categories of the substantive theory.

The substantive theory is the first to emerge from hospital-based home care services in Taiwan. Results showed those services had several effective functions for helping people with severe mental illness and their families.

The recommendations based on the findings of this research can be used as a guide to improve the delivery of hospital-based home care services to community-dwelling people with severe mental illness and their carers.