Department of Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium.
Academic Chair Active Ageing, Vrije Universiteit Brussel, Brussels, Belgium.
Health Soc Care Community. 2019 May;27(3):632-641. doi: 10.1111/hsc.12676. Epub 2018 Oct 30.
Frail, older care recipients are often thought of as individuals with a decreased mastery of everyday life skills. Various authors have proposed to acknowledge a relational dimension of mastery, defined as the ability to maintain control over one's life with the help of others. This study explores how frail, older adults experience relational aspects of mastery and the role of their informal caregivers in maintaining these aspects of mastery over the care process. Qualitative interviews (N = 121) were conducted in 2016 with potentially frail, community-dwelling older adults participating in the Detection, Support and Care for Older people: Prevention and Empowerment (D-SCOPE) project. A secondary analysis of 65 interviews reveals that, according to frail, older adults, informal caregivers contribute in various ways to the preservation of their mastery. This differs across the four elements of care: caring about (attentiveness), taking care of (responsibility), care-giving (competence), and care-receiving (responsiveness). However, in some cases, older adults experienced a loss of mastery; for example, when informal caregivers did not understand their care needs and did not involve them in the decision, organisation, and provision of care. A relational dimension of mastery needs to be acknowledged in frail, older care recipients since stimulating mastery is a crucial element for realising community care objectives and person-centred and integrated care.
体弱、年老的护理对象通常被认为是日常生活技能下降的个体。许多作者提出承认掌握能力的关系维度，即借助他人维持对生活的控制的能力。本研究探讨了体弱、老年人如何体验掌握能力的关系方面，以及他们的非正式照顾者在维持这些掌握能力方面在护理过程中的作用。2016 年，与潜在体弱、居住在社区的老年人进行了定性访谈（N=121），这些老年人参与了 Detection、Support and Care for Older people: Prevention and Empowerment（D-SCOPE）项目。对 65 次访谈的二次分析表明，根据体弱老年人的说法，非正式照顾者以各种方式为保持他们的掌握能力做出贡献。这在四个护理元素方面有所不同：关心（关注）、照顾（责任）、照顾（能力）和接受照顾（响应）。然而，在某些情况下，老年人会失去掌握能力；例如，当非正式照顾者不了解他们的护理需求，并且不与他们一起参与护理的决策、组织和提供时。在体弱的老年护理对象中需要承认掌握能力的关系维度，因为激发掌握能力是实现社区护理目标以及以人为本和综合护理的关键要素。
