1. From risky to safer home care: health care assistants striving to overcome a lack of training, supervision, and support
- Author
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Lena Törnkvist, Eva Hammar Chiriac, Ingrid Hylander, Lena Swedberg, and The study was conducted with support from the regional agreement on medical training and clinical research (ALF) between Stockholm County Council and Karolinska Institutet, Sweden
- Subjects
Empirical Study ,Adult ,Male ,training needs ,Attitude of Health Personnel ,Social Sciences ,Caring Science ,Nursing ,Empirical Research ,Grounded theory ,Home care ,Interviews as Topic ,Patient safety ,Young Adult ,Empirical research ,Professional Competence ,SAFER ,Health care ,Medicine ,Humans ,Competence (human resources) ,Sweden ,Keywords: Home care, homecare technology, paraprofessional caregivers, training needs, grounded theory ,lcsh:R5-920 ,business.industry ,Health Policy ,Samhällsvetenskap ,home care technology ,Professional-Patient Relations ,Middle Aged ,Home Care Services ,Work experience ,Issues, ethics and legal aspects ,Caregivers ,paraprofessional caregivers ,Fundamentals and skills ,Training needs ,Female ,Patient Safety ,business ,lcsh:Medicine (General) ,Gerontology ,grounded theory - Abstract
Patients receiving home care are becoming increasingly dependent upon competent caregivers’ 24-h availability due to their substantial care needs, often with advanced care and home care technology included. In Sweden, care is often carried out by municipality-employed paraprofessionals such as health care assistants (HC assistants) with limited or no health care training, performing advanced care without formal training or support. The aim of this study was to investigate the work experience of the HC assistants and to explore how they manage when delivering 24-h home care to patients with substantial care needs. Grounded theory methodology involving multiple data sources comprising interviews with HC assistants (n19) and field observations in patients’ homes was used to collect data and constant comparative analysis was used for analysis. The initial analysis revealed a number of barriers, competence gap; trapped in the home setting; poor supervision and unconnected to the patient care system, describing the risks associated with the situations of HC assistants working in home care, thus affecting their working conditions as well as the patient care. The core process identified was the HC assistants’ strivings to combine safe home care with good working conditions by using compensatory processes. The four identified compensatory processes were: day-by-day learning; balancing relations with the patient; self-managing; and navigating the patient care system. By actively employing the compensatory processes, the HC assistants could be said to adopt an inclusive approach, by compensating for their own barriers as well as those of their colleagues’ and taking overall responsibility for their workplace. In conclusion, the importance of supporting HC assistants in relation to their needs for training, supervision,and support from health care professionals must be addressed when organising 24-h home care to patients with substantial care needs in the future. Key words: Home care, home care technology, paraprofessional caregivers, training needs, grounded theory (Published: 23 May 2013) Citation: Int J Qualitative Stud Health Well-being 2013, 8 : 20758 - http://dx.doi.org/10.3402/qhw.v8i0.20758
- Published
- 2013