Perceptions of providing safe care for frail older people at home: A qualitative study based on focus group interviews with home care staff

Silverglow, Anastasia; Johansson, Lena; Lidén, Eva; Wijk, Helle

doi:10.1111/scs.13027

Cited by 12 publications

(17 citation statements)

References 40 publications

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“…Care staff play an important role in the lives of older adults receiving home care support services. 32 This study reflected this, with participants reporting strengthened relationships, which at times led to improved independence. However, maintaining care staff within an organization is a challenging prospect for many home care support organizations, not only those in Ireland.…”

Section: Discussionmentioning

confidence: 58%

A Qualitative Study of Older Adults’ Experiences of Embedding Physical Activity Within Their Home Care Services in Ireland

Burton¹,

Horgan²,

Cummins³

et al. 2022

JMDH

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Purpose Physical activity has been shown to improve older adults’ functional capacity, independence, and quality of life. In a feasibility study, we embedded a movement approach within older adults existing home care services through “Care to Move” (CTM). The aim of this qualitative study is to explore older adults’ experiences of CTM within their home care support services and to identify the strengths and barriers of engaging in CTM from the perspective of the older recipient. Materials and Methods We conducted semi-structured telephone interviews with 13 older adults and one informal carer. Topics covered included participants’ overall experiences of CTM, changes to their overall activity and participation, aspects of CTM that they found valuable and issues that were challenging. Interview transcripts were coded and analyzed thematically to capture barriers and facilitators to the approach delivery. Results Four themes were developed: i) “I have good days and bad days”, ii) “safety and security is the name of the game”, iii) “we’re a team as it stands’, iv) “it’s [COVID-19] depressing for everybody at the moment”. Older adults identified benefits of CTM engagement including improvements in physical and psychological wellbeing. However, subjective frailty and self-reported multimorbidity influenced overall engagement. Participants expressed concerns around the logistics of delivering CTM and competing care staff interests. The broader role of care staff in supporting CTM was highlighted, as well as the emotional support that staff provided to older adults. Care staff continuity was identified as a barrier to ongoing engagement. The impact of COVID-19 on older adults physical and mental health negatively impacted the delivery of the approach. Conclusion Our findings suggest that embedding CTM within home care services is feasible and that older adults enjoyed engaging in CTM. Addressing care staff continuity and adopting individual approaches to CTM delivery may enhance the implementation of services.

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Section: Discussionmentioning

confidence: 58%

A Qualitative Study of Older Adults’ Experiences of Embedding Physical Activity Within Their Home Care Services in Ireland

Burton¹,

Horgan²,

Cummins³

et al. 2022

JMDH

View full text Add to dashboard Cite

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“…Increasing knowledge of the multi‐factorial nature of loneliness and social isolation, creating links with other local health, aged and social care providers and documenting appropriate referral pathways can assist with a holistic person‐centred response [3,5,56]. According to Gale [26], “the nursing role in holistic care is to attain and maintain wellness by supporting not only physiological needs but the psychological and psychosocial needs of the individual.” This holistic response recognises the importance of addressing social, emotional and physical well‐being where “…caring means listening to the older person with the desire to understand their complex needs” [64]. The role of the nurse in primary care is evolving, however, there remain opportunities to better utilise this workforce [65,66].…”

Section: Discussionmentioning

confidence: 99%

“…According to Gale [26], "the nursing role in holistic care is to attain and maintain wellness by supporting not only physiological needs but the psychological and psychosocial needs of the individual." This holistic response recognises the importance of addressing social, emotional and physical well-being where "…caring means listening to the older person with the desire to understand their complex needs" [64]. The role of the nurse in primary care is evolving, however, there remain opportunities to better utilise this workforce [65,66].…”

Section: Discussionmentioning

confidence: 99%

The contribution of primary care practitioners to interventions reducing loneliness and social isolation in older people—An integrative review

Thompson

Halcomb

Masso

2023

Scandinavian Caring Sciences

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BackgroundSocial connection is a fundamental human need. Its absence can lead to loneliness and social isolation, adversely impacting health and well‐being. Given their regular contact and trusted relationships with older people, practitioners delivering community‐based primary care are well‐positioned to address this issue. However, their contribution to addressing loneliness and social isolation is unclear.AimThis integrative review explores the contribution of the primary care workforce to interventions aimed at reducing loneliness and social isolation in community‐dwelling older people.MethodUsing an integrative review method, Scopus, Web of Science, CINAHL and PubMed were searched for original research published between 2000 and 2022. Fourteen papers reporting 13 primary studies were appraised for methodological quality and included in the review. Data were extracted into a summary table and analysed using thematic analysis.ResultsIncluded studies came from over six countries. Internationally, primary care services have diverse structures, funding and workforces influencing their response to loneliness and social isolation. All but one intervention was multi‐component, with ten studies including a group‐based activity and three providing primarily individual‐level activities. Only six studies reported reductions in loneliness following the intervention. Three themes were identified: characteristics of interventions; implementation context, barriers and facilitators; and differing contributions of primary care practitioners in addressing loneliness and social isolation of older people.ConclusionThere is increasing demand and scope for primary care practitioners to assist lonely and socially isolated older people. It is important to understand how to equip and incentivise these practitioners to routinely identify, assess and respond to lonely and socially isolated older people despite varying implementation contexts. There is a need for further research that explores how the primary care team can be better utilised to deliver effective interventions that reduce the health impacts of loneliness and social isolation.

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“…The political ideals for cross-sectoral collaboration should be understood in the light of citizens' and health professionals' experiences of a lack of coherence in the cross-sectoral treatment and care pathways, as described in the research literature [5,6]. It appears that inadequate communication between the two sectors is a widespread international phenomenon that also includes the Nordic welfare states [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Cross‐sectoral exchange of nurses: An intervention study

Jungdal,

Tousig,

Christiansen

et al. 2024

Scandinavian Caring Sciences

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BackgroundIn health policy, much attention has been paid to collaboration between the primary and secondary health care sectors, especially in relation to hospitalisation and discharge. Despite ideal plans for collaboration, the research literature shows that inadequate communication is a well‐known problem that can be a barrier to a safe trajectory for the citizen. Based on the assumption that better knowledge of each other's work will lead to better collaboration, a cross‐sectoral exchange program with nurses was initiated.AimThe aim was to investigate which barriers to good patient trajectories the involved nurses attributed to cross‐sectoral collaboration and what impact the exchange to the opposite sector had for them.MethodsTwenty‐eight nurses were exchanged: 14 from a cardiology department and 14 from municipal home care. The nurses shadowed a colleague from the opposite sector in their daily work. Subsequently, six focus group interviews were conducted. The transcribed material was analysed based on Ricoeur's interpretation theory.ResultsTwo main themes, including sub‐themes emerged: (1) Challenging communicative conditions: (a) Inadequate digital communication, (b) Inadequate care plans and discharge reports, (c) Conversation promotes understanding, and (d) Challenging collaboration and communication with the discharge coordinators. (2) Perceived importance of the exchange: (a) Cross‐sectoral relationship, prejudice and gaining respect for each other and (b) Working in two different worlds.ConclusionElectronic communication is inadequate, and the IT systems do not support sufficient cross‐sectoral communication. The organisational model in the municipal care sector is inflexible in terms of allocations for the current needs of citizens, and professionals feel that their professional judgements are not recognised. The nurses gained insight into each other's work and working conditions and respect for each other's professionalism. The exchange has the potential to both improve the relationship and communication between the sectors for the benefit of a better and more coherent patient course.

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Perceptions of providing safe care for frail older people at home: A qualitative study based on focus group interviews with home care staff

Abstract: This is an open access article under the terms of the Creat ive Commo ns Attri butio n-NonCo mmerc ial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 12 publications

References 40 publications

A Qualitative Study of Older Adults’ Experiences of Embedding Physical Activity Within Their Home Care Services in Ireland

A Qualitative Study of Older Adults’ Experiences of Embedding Physical Activity Within Their Home Care Services in Ireland

The contribution of primary care practitioners to interventions reducing loneliness and social isolation in older people—An integrative review

Cross‐sectoral exchange of nurses: An intervention study

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