Institute of Nursing, Zurich University Applied Sciences, Winterthur, Switzerland.
Witten/Herdecke University, Witten, Germany.
Health Soc Care Community. 2019 May;27(3):e95-e111. doi: 10.1111/hsc.12663. Epub 2018 Oct 11.
Often family members provide care-giving, which allows older adults to remain in their homes. With declining health and increasing frailty, care-giving of elderly people becomes a task of family caregivers (FC) in conjunction with home care nurses. It has been shown in both acute care settings and long-term care facilities that family members prefer to be involved in decision-making and care planning for their next of kin. Therefore, an integrative review was conducted to explore the body of knowledge of FCs' involvement in home-care settings from the FCs' perspective. CINAHL, PubMed, and Cochrane databases was searched with the terms family caregiver, involvement, home care, and community dwelling. Studies written in German or English between 1996 and 2017 focusing on FCs' caring for home-dwelling older adults together with home care nurses were included and critically appraised. The extracted findings were analysed with concept analysis method. Twenty-six studies were included and five themes were identified. Four themes formed the basis of assistance towards family caregivers by nurses and included "relationship building with professionals," "negotiating with professional care," "being professionally supported," and "managing role expectations and knowledge sharing". The fifth theme, "working together" described the mutual care for the care recipient. Although the first four themes were consistent with a pre-existing conceptual model by Sims-Gould and Marin-Matthews (2010), the fifth required an expansion of the model with an additional contribution "collaborative practice". The findings illustrate that involvement in care is an interactional process, which provides the basis for collaborative practices with the home care nurses for family caregivers. Family members often want to be part of the healthcare team, and nurses need contextual factors that allow providing their full range of skills and knowledge to involve family caregivers accordingly.
家庭成员经常提供护理，这使老年人能够留在自己的家中。随着健康状况的下降和脆弱性的增加，老年人的护理成为家庭护理员（FC）与家庭护理护士共同承担的任务。在急性护理环境和长期护理设施中都已经表明，家庭成员更喜欢参与其近亲的决策和护理计划。因此，进行了一项综合审查，以从家庭护理员的角度探索家庭护理环境中家庭护理员参与的知识体系。使用家庭护理员、参与、家庭护理和社区居住等术语，在 CINAHL、PubMed 和 Cochrane 数据库中进行了搜索。纳入并批判性评价了 1996 年至 2017 年期间用德语或英语撰写的、重点关注家庭护理员与家庭护理护士一起照顾居家老年人的研究。使用概念分析方法对提取的结果进行了分析。共纳入 26 项研究，确定了 5 个主题。其中 4 个主题构成了护士对家庭护理员的援助基础，包括“与专业人员建立关系”、“与专业护理协商”、“得到专业支持”和“管理角色期望和知识共享”。第五个主题“共同工作”描述了对护理对象的相互护理。尽管前四个主题与 Sims-Gould 和 Marin-Matthews（2010 年）的现有概念模型一致，但第五个主题需要用“协作实践”的额外贡献来扩展该模型。研究结果表明，参与护理是一个相互作用的过程，为家庭护理员与家庭护理护士进行协作实践提供了基础。家庭成员通常希望成为医疗团队的一部分，而护士需要考虑到使他们能够充分发挥技能和知识的环境因素，以便相应地让家庭成员参与护理。
