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对孟加拉国和巴基斯坦社会护理使用者服务满意度较低原因的合作性探究。

A collaborative exploration of the reasons for lower satisfaction with services among Bangladeshi and Pakistani social care users.

作者信息

Blake Margaret, Bowes Alison, Gill Valdeep, Husain Fatima, Mir Ghazala

机构信息

Ipsos MORI, London, UK.

Faculty of Social Sciences, University of Stirling, Stirling, UK.

出版信息

Health Soc Care Community. 2017 May;25(3):1090-1099. doi: 10.1111/hsc.12411. Epub 2016 Nov 25.

Abstract

This study explored underlying reasons for the expression of dissatisfaction with services among Bangladeshi and Pakistani social care users in England and investigated, using a collaborative approach, how these could be addressed. In-depth interviews were conducted in Birmingham, Leeds and London during 2012-2013 with 63 Bangladeshi, Pakistani and white British service users and 24 social care managers, social workers and care workers. A further 34 cognitive interviews were conducted within the same study. Following data analysis, three collaborative workshops involving service users and providers were held to validate the findings and to draw out policy and practice recommendations. Analysis of the cognitive interviews showed that higher dissatisfaction among Bangladeshi and Pakistani service users reported in social care surveys was not due to questionnaire design. Instead in-depth interviews showed that dissatisfaction across all three groups was expressed along the social care journey, including accessing care, communication with social workers and the nature of care received. While many issues were common to all three groups, cultural differences also emerged as affecting experiences of social care. These included misunderstandings about family roles in care; gender issues, especially relating to women; language and communication barriers, alongside the need for a more nuanced approach to ethnic 'matching'; and continuing limited cultural understanding among care workers. The collaborative workshops identified practical actions that could address some of the issues identified. These covered raising awareness of services within communities; improving support for informal carers; service user input to assessments; consistent and ongoing sharing of information; improving access; and more efforts to diversify and appropriately train the social care workforce. In conclusion, the paper presents the reality of dissatisfaction among these groups and argues for more action involving communities and service providers to address these persistent issues collaboratively.

摘要

本研究探讨了在英国的孟加拉裔和巴基斯坦裔社会护理使用者对服务表达不满的潜在原因,并采用合作方法调查了如何解决这些问题。2012年至2013年期间,在伯明翰、利兹和伦敦对63名孟加拉裔、巴基斯坦裔和英国白人服务使用者以及24名社会护理经理、社会工作者和护理人员进行了深入访谈。在同一研究中还进行了另外34次认知访谈。数据分析后,举办了三场由服务使用者和提供者参与的合作研讨会,以验证研究结果并得出政策和实践建议。认知访谈分析表明,社会护理调查中报告的孟加拉裔和巴基斯坦裔服务使用者较高的不满并非源于问卷设计。相反,深入访谈显示,所有三个群体在整个社会护理过程中都表达了不满,包括获得护理、与社会工作者沟通以及所接受护理的性质。虽然所有三个群体都存在许多共同问题,但文化差异也影响了社会护理体验。这些差异包括对家庭在护理中的角色存在误解;性别问题,特别是与女性相关的问题;语言和沟通障碍,以及需要采取更细致入微的族裔“匹配”方法;护理人员对文化的理解仍然有限。合作研讨会确定了一些可以解决所发现问题的实际行动。这些行动包括提高社区内对服务的认识;加强对非正式护理人员的支持;让服务使用者参与评估;持续一致地分享信息;改善获得服务的机会;以及做出更多努力,使社会护理劳动力多样化并进行适当培训。总之,本文呈现了这些群体不满的现实情况,并主张社区和服务提供者采取更多行动,共同协作解决这些长期存在的问题。

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