Slatyer Susan, Aoun Samar M, Hill Keith D, Walsh Debbie, Whitty Dee, Toye Christine
Discipline of Nursing, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Western Australia, 6150, Australia.
School of Nursing, Midwifery and Paramedicine, Curtin University , GPO Box U1987, Perth, Western Australia, 6845, Australia.
BMC Health Serv Res. 2019 Apr 11;19(1):220. doi: 10.1186/s12913-019-4042-0.
The ageing global population has seen increasing numbers of older people living with chronic health problems, declining function, and frailty. As older people seek to live out their years at home, family members, friends and neighbours (informal caregivers) are increasingly relied upon for support. Moreover, pressured health systems and shorter hospital length of stay mean that informal caregivers can find themselves supporting the older person who is still unwell after discharge. The Further Enabling Care at Home (FECH) program was developed as a nursing outreach intervention designed to systematically address support needs of family caregivers of older people after hospital discharge to sustain their home-based caregiving. The objective of this study was to explore the experiences of informal caregivers who participated in the FECH program after an older family member's discharge from hospital.
The study employed a qualitative descriptive design. Caregivers of older people discharged home from a Medical Assessment Unit in an Australian hospital who were included in the program were interviewed to explore their experiences and perceptions of the FECH program. Data were audio-recorded, transcribed, and subjected to thematic analysis.
Twenty-one family caregivers (81% female, aged 25-89 years) participated in the interviews. Themes emerging were 'The experience of caregiving'; 'The experience of receiving FECH program support'; and 'Caregivers' suggestions for improvement'. Caregivers indicated that reflective discussions with the FECH nurse enabled them to recognise the complexity of the caregiving role and determine aspects where they needed support. Caregivers valued guidance from the FECH nurse in accessing information and resources, which helped them to feel more connected to support, more prepared to care for the older person and themselves, and more secure in the caregiving role.
Caregivers' experiences indicated that the structured reflective FECH discussions prompted thought and provided guidance in navigating health and care systems. The FECH program appears to offer a means to address the practical, physical and psychosocial needs of informal caregivers as partners in person-centred health and social care.
ANZCTR Trial ID: ACTRN126140011746773 .
全球人口老龄化，患有慢性健康问题、功能衰退和身体虚弱的老年人数量不断增加。随着老年人希望在家中安度晚年，家庭成员、朋友和邻居（非正式照护者）越来越多地被依赖来提供支持。此外，医疗系统压力大以及住院时间缩短意味着非正式照护者可能会发现自己要支持出院后仍未康复的老年人。“进一步在家中促进照护”（FECH）项目是作为一种护理外展干预措施而制定的，旨在系统地满足老年人出院后家庭照护者的支持需求，以维持他们的居家照护。本研究的目的是探讨老年家庭成员出院后参加FECH项目的非正式照护者的经历。
本研究采用定性描述性设计。对澳大利亚一家医院医疗评估单元出院回家且被纳入该项目的老年人的照护者进行访谈，以探讨他们对FECH项目的经历和看法。数据进行了录音、转录，并进行了主题分析。
21名家庭照护者（81%为女性，年龄在25 - 89岁之间）参与了访谈。出现的主题有“照护经历”；“接受FECH项目支持的经历”；以及“照护者的改进建议”。照护者表示，与FECH护士进行反思性讨论使他们能够认识到照护角色的复杂性，并确定他们需要支持的方面。照护者重视FECH护士在获取信息和资源方面的指导，这帮助他们感觉与支持联系更紧密，更有准备照顾老年人和自己，并且在照护角色中更有安全感。
照护者的经历表明，结构化的反思性FECH讨论引发了思考，并在应对健康和照护系统方面提供了指导。FECH项目似乎提供了一种方式，来满足非正式照护者作为以患者为中心的健康和社会照护伙伴的实际、身体和心理社会需求。
澳大利亚和新西兰临床试验注册中心试验编号：ACTRN126140011746773 。
