Al-Janabi Hareth, Coast Joanna, Flynn Terry N
University of Bristol, Bristol, UK.
Soc Sci Med. 2008 Jul;67(1):111-21. doi: 10.1016/j.socscimed.2008.03.032. Epub 2008 Apr 23.
Government policies to shift care into the community and demographic changes mean that unpaid (informal) carers will increasingly be relied on to deliver care, particularly to older people. As a result, careful consideration needs to be given to informal care in economic evaluations. Current methods for economic evaluations may neglect important aspects of informal care. This paper reports the development of a simple measure of the caring experience for use in economic evaluations. A meta-ethnography was used to reduce qualitative research to six conceptual attributes of caring. Sixteen semi-structured interviews were then conducted with carers of older people, to check the attributes and develop them into the measure. Six attributes of the caring experience comprise the final measure: getting on, organisational assistance, social support, activities, control, and fulfilment. The final measure (the Carer Experience Scale) focuses on the process of providing care, rather than health outcomes from caring. Arguably this provides a more direct assessment of carers' welfare. Following work to test and scale the measure, it may offer a promising way of incorporating the impact on carers in economic evaluations.
政府将医疗护理转向社区的政策以及人口结构的变化意味着，无薪（非正式）护理人员将越来越多地被依赖来提供护理服务，尤其是为老年人提供护理。因此，在经济评估中需要仔细考虑非正式护理。当前的经济评估方法可能会忽略非正式护理的重要方面。本文报告了一种用于经济评估的简单护理体验衡量方法的开发过程。采用元民族志方法将定性研究归纳为护理的六个概念属性。随后对老年护理人员进行了16次半结构化访谈，以检验这些属性并将其发展为衡量方法。护理体验的六个属性构成了最终的衡量方法：相处融洽、组织协助、社会支持、活动、掌控感和成就感。最终的衡量方法（护理人员体验量表）关注的是提供护理的过程，而非护理带来的健康结果。可以说，这提供了对护理人员福利的更直接评估。在对该衡量方法进行测试和调整的工作之后，它可能为将对护理人员的影响纳入经济评估提供一种有前景的方式。
