Faculté des sciences infirmières, Université de Montréal, and Researcher, Centre de recherche, Institut universitaire de gériatrie de Montréal, 4565 chemin Queen-Mary, Montréal (Qc), Canada H3W 1W5.
Int J Nurs Stud. 2010 Jul;47(7):876-87. doi: 10.1016/j.ijnurstu.2009.12.006. Epub 2010 Mar 1.
BACKGROUND: As the global population ages, support for family caregivers who provide the bulk of care to community-dwelling older people is becoming ever more important. However, in many countries, homecare-service practitioners currently do not follow a systematic approach to assessing and responding to caregiver needs. OBJECTIVES: The aim of this study was to explore the experiences of caregivers and practitioners who took part in a field test of the Family Caregivers Support Agreement (FCSA) tool, a modified version of the Carers Outcome Agreement Tool (COAT) initially developed as the result of an Anglo-Swedish study. Both the COAT and the FCSA are designed to facilitate partnerships between caregivers and practitioners so that needs assessment and subsequent support services are negotiated and agreed so as to meet caregiver expectations. DESIGN AND PARTICIPANTS: A qualitative design was adopted and data were collected through focus groups with six practitioners (nurses and social workers) working in two Local Community Service Centres in the province of Quebec (Canada). These practitioners had previously completed the FCSA tool with 17 primary caregivers of frail elderly relatives who were clients of homecare services. Individual interviews were conducted with the caregivers to explore their experiences. Data were analyzed to identify significant themes, from the perspectives of caregivers and practitioners, which provided insights into their experiences and the strategies used by practitioners to facilitate partnership working. FINDINGS: To facilitate meaningful exchanges, practitioners adopted strategies such as sensitive listening and the use of enabling questions to identify and contextualize caregiver needs and to highlight the ability of caregivers to find their own creative solutions to the challenges they face. The caregivers described experiencing a climate of trust that allowed them to express their concerns, to reflect upon their situation and to participate in the development of an action plan for their support. CONCLUSIONS: The study reaffirms findings from Sweden and UK that the use of a tool such as the FCSA enhances partnership working and creates a caregiver-practitioner relationship based on a genuine alliance. As a result, both parties gain new insights into the caring situation. The approach underpinning the FCSA tool has potential for a more widespread application in different contexts.
背景:随着全球人口老龄化,对为居住在社区的老年人提供大部分护理的家庭照顾者的支持变得越来越重要。然而,在许多国家,家庭护理服务从业者目前没有采取系统的方法来评估和满足照顾者的需求。
目的:本研究旨在探讨参与家庭照顾者支持协议(FCSA)工具现场测试的照顾者和从业者的经验,该工具是最初作为英瑞研究结果开发的照顾者结果协议工具(COAT)的修改版本。COAT 和 FCSA 都旨在促进照顾者和从业者之间的伙伴关系,以便进行需求评估和随后的支持服务协商和达成协议,以满足照顾者的期望。
设计和参与者:采用定性设计,通过在魁北克省(加拿大)两个地方社区服务中心工作的六名从业者(护士和社会工作者)的焦点小组收集数据。这些从业者之前曾与 17 名体弱老年人亲属的主要照顾者一起完成了 FCSA 工具,这些亲属是家庭护理服务的客户。对照顾者进行了单独访谈,以探讨他们的经验。从照顾者和从业者的角度分析数据,以确定重要主题,从而深入了解他们的经验以及从业者促进伙伴关系的策略。
发现:为了促进有意义的交流,从业者采取了一些策略,例如敏感倾听和使用启发性问题来识别和背景化照顾者的需求,并强调照顾者有能力找到自己创造性的解决方案来应对他们所面临的挑战。照顾者描述了他们感受到了一种信任的氛围,使他们能够表达自己的担忧,反思自己的情况,并参与制定支持计划。
结论:该研究重申了瑞典和英国的研究结果,即使用 FCSA 等工具可以增强伙伴关系,并建立基于真正联盟的照顾者与从业者关系。因此,双方都对照顾情况有了新的认识。FCSA 工具所依据的方法有可能在不同的背景下更广泛地应用。
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