School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand.
Health Soc Care Community. 2012 Jan;20(1):70-9. doi: 10.1111/j.1365-2524.2011.01020.x. Epub 2011 Aug 5.
Paid caregivers possess an essential role in home care services. However, recruitment and retention issues are extensive within this workforce, largely in relation to poor working conditions. This article primarily focuses on the qualitative data extracted from a large randomised controlled trial in New Zealand and is supported by some quantitative findings. The aim was to explore paid caregiver perceptions of a restorative home care intervention in comparison with usual home care. The purpose of the qualitative exploration was to gather rich descriptive data that highlight differences between the two services with an emphasis on the workforce viewpoint. Four focus groups were undertaken with paid caregivers, two at baseline (4 and 5 participants in the control and intervention groups, respectively) and two at 14 months (eight participants in each focus group). Focus group data were collected in December 2005 and February 2007. A general inductive approach was used to analyse focus group transcripts. Two themes emerged from both the control and intervention focus groups: relationship with older people and issues with home care service delivery. A further two themes were pertinent to the intervention group: job satisfaction and preintervention. Findings revealed the intervention had a substantial positive impact on paid caregiver job satisfaction in comparison with usual care. This appeared to be due to improved training, increased support and supervision, and more flexibility. The intervention resulted in positive changes from the paid caregiver perspective and substantially reduced turnover in comparison with usual home care. However, both groups identified the need for further improvements to their working conditions. In addition, the need to regulate this vulnerable workforce is discussed.
付费护工在家政服务中扮演着重要的角色。然而，这个劳动力群体普遍存在招聘和留用问题，主要与工作条件差有关。本文主要关注从新西兰一项大型随机对照试验中提取的定性数据，并结合一些定量发现。目的是探讨付费护工对康复性家庭护理干预与常规家庭护理的看法。这项定性探索的目的是收集丰富的描述性数据，突出两种服务之间的差异，重点是劳动力的观点。对付费护工进行了四次焦点小组讨论，两次在基线（对照组和干预组各有 4 名和 5 名参与者），两次在 14 个月时（每个焦点小组 8 名参与者）。焦点小组数据于 2005 年 12 月和 2007 年 2 月收集。采用一般归纳方法分析焦点小组记录。对照组和干预组的焦点小组都出现了两个主题：与老年人的关系和家庭护理服务提供问题。另外两个主题与干预组有关：工作满意度和干预前。研究结果表明，与常规护理相比，干预对付费护工的工作满意度产生了实质性的积极影响。这似乎是由于培训、支持和监督的增加以及更多的灵活性。从付费护工的角度来看，干预带来了积极的变化，与常规家庭护理相比，离职率大大降低。然而，两组都认为需要进一步改善他们的工作条件。此外，还讨论了规范这个脆弱劳动力的必要性。
