Wong-Cornall Cecilia, Parsons John, Sheridan Nicolette, Kenealy Timothy, Peckham Allie
School of Nursing, School of Population Health, University of Auckland, Private Bag 92019, Auckland 1142, NZ.
School of Nursing, University of Auckland, Private Bag 92019, Auckland 1142, NZ.
Int J Integr Care. 2017 Jun 27;17(2):11. doi: 10.5334/ijic.2545.
Family carers, as a "shadow workforce", are foundational to the day-to-day integration of health service delivery for older family members living with complex health needs. This paper utilises Haggerty's model of continuity of care to explore the contribution of family carers' to the provision of care and support for an older family member's chronic condition within the context of health service delivery.
We analysed data from interviews of 13 family carers in a case study of primary health care in New Zealand - a Maori Provider Organisation - to determine the alignment of family caregiving with the three levels of continuity of care (relational continuity, informational continuity, and management continuity).
We found alignment of family caregiving tasks, responsibilities, and relationships with the three levels of continuity of care. Family carers 1) partnered with providers to extend chronic care to the home; 2) transferred and contributed information from one provider/service to another; 3) supported consistent and flexible management of care.
The Maori Provider Organisation supported family carer-provider partnership enabled by shared Maori cultural values and social mandate of building family-centred wellbeing. Relational continuity was the most important level of continuity of care; it sets precedence for family carers and providers to establish the other levels - informational and management - continuity of care for their family member cared for. Family carers need to be considered as active partners working alongside responsive primary health care providers and organisation in the implementation of chronic care.
家庭照顾者作为“影子劳动力”，对于为有复杂健康需求的老年家庭成员提供日常医疗服务至关重要。本文运用哈格蒂的连续性护理模型，探讨在医疗服务提供的背景下，家庭照顾者对为老年家庭成员的慢性病提供护理和支持所做的贡献。
在新西兰一个毛利人服务机构进行的初级卫生保健案例研究中，我们分析了对13名家庭照顾者的访谈数据，以确定家庭照顾与三个连续性护理水平（关系连续性、信息连续性和管理连续性）的一致性。
我们发现家庭照顾任务、责任和关系与三个连续性护理水平一致。家庭照顾者：1）与提供者合作，将慢性病护理延伸至家中；2）在不同提供者/服务之间传递并提供信息；3）支持护理的一致且灵活的管理。
毛利人服务机构通过共享的毛利文化价值观和构建以家庭为中心的福祉的社会使命，支持家庭照顾者与提供者的伙伴关系。关系连续性是连续性护理中最重要的水平；它为家庭照顾者和提供者确立其他水平——信息和管理——即对其照顾的家庭成员的护理连续性设定了优先顺序。在慢性病护理的实施中，家庭照顾者应被视为与积极响应的初级卫生保健提供者和机构并肩工作的积极伙伴。
