Structures and objectives of day hospices - Design of a logic model.

Abstract

Background: Day hospices represent a new component of outpatient palliative care in Germany. They focus on improving the quality of life and symptom control for patients with advanced, incurable diseases and aim to relieve the burden on family caregivers. However, a uniform theoretical framework for day hospices has not yet been established.

Methods: To develop a logic model for day hospices, data were obtained from a retrospective literature review and qualitative, semi-structured telephone interviews with 11 patients and 5 relatives. The logic model was developed by the author team using a nominal group process and subsequently cross-checked by five patients and two staff members of a day hospice.

Results: The final logic model comprised 18 categories and 105 program elements, organized into five pillars: resources, activities, output, outcome, and impact. It describes the functioning of a day hospice and its expected short- and long-term effects logically and coherently, based on key organizational, structural, and personnel requirements, as well as the services and interventions based on these requirements.

Conclusions: The developed logic model provides an initial program theory for day hospices. It offers a clear and structured framework for understanding their functions and expected outcomes. The model can serve as a practical foundation for establishing new day hospices and for guiding future research and quality development in this emerging area of palliative care.

Trial registration: The study was registered as part of the IMPULS-Study in the German Register of Clinical Studies (DRKS-ID: DRKS00031613; Date of registration: 04 April 2023) and the Display portal of the Center for Clinical Studies of the University Hospital Regensburg (Z-2022-1734-6; Date of registration: 01 October 2022).