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成为日常活动的推动者:家庭护理服务中的健康专业人员在协助恢复能力方面的工作经历。

Becoming an enabler of everyday activity: Health professionals in home care services experiences of working with reablement.

作者信息

Liaaen Janne, Vik Kjersti

机构信息

Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.

出版信息

Int J Older People Nurs. 2019 Dec;14(4):e12270. doi: 10.1111/opn.12270. Epub 2019 Sep 5.

Abstract

BACKGROUND

Reablement services aim at improving participation in everyday activities at home and in the local community for older adults, focusing on the older adults' resources and goal for participation. Reablement services have been implemented in a number of municipalities in Scandinavia. To our knowledge, there are a few studies focusing on home care service providers experience working within the frame of reablement.

AIM

To provide knowledge regarding how home care service providers working with reablement in the home care setting describe their experiences.

METHODS

The study had a qualitative design and included five focus group discussions with 25 healthcare professionals working in community health care in two municipalities. The data were analysed using a grounded theory approach.

RESULT

The analysis illustrated how the participants experienced both engagement and challenges working with reablement. This was identified by the two categories: creating sustainable change and negotiating the line between helping and enabling. The first described how increased focus on enabling participation among the service recipients created sustainable changes for the older adults and was considered a positive change for both the recipients and the health professionals. The latter showed how the participants found working with reablement as a process of negotiation. This was what the health professionals found most challenging with reablement.

CONCLUSION

Working within the frame of reablement offered the service providers, a framework for being more flexible in meeting the fluctuating needs of the older adults. This was done by increasingly utilise ones' clinical skills and changing from providing passive care to working on increasing the older persons' participation in everyday activities. Working with reablement also created challenges. This was related to the health professionals perceived expectations of what some of the older adults expected home care to be and caused ambivalence.

IMPLICATIONS FOR PRACTICE

Nurses and healthcare workers should focus on older adults' resources and goals in order to give services that enhance participation in daily activities.

摘要

背景

康复服务旨在提高老年人在家中和当地社区参与日常活动的能力,重点关注老年人的资源和参与目标。斯堪的纳维亚半岛的一些城市已经实施了康复服务。据我们所知,很少有研究关注家庭护理服务提供者在康复框架内工作的经验。

目的

了解家庭护理环境中从事康复工作的家庭护理服务提供者如何描述他们的经验。

方法

本研究采用定性设计,包括与两个城市社区卫生保健领域的25名医护人员进行的五次焦点小组讨论。数据采用扎根理论方法进行分析。

结果

分析表明,参与者在从事康复工作时既体验到了参与感,也面临着挑战。这通过两个类别得以体现:创造可持续的改变以及在帮助与赋能之间进行权衡。第一类描述了如何通过更多地关注使服务对象能够参与活动,为老年人带来可持续的改变,这对服务对象和健康专业人员而言都是积极的变化。第二类则展示了参与者如何将从事康复工作视为一个权衡的过程。这是健康专业人员在康复工作中发现最具挑战性的方面。

结论

在康复框架内工作为服务提供者提供了一个更灵活地满足老年人不断变化需求的框架。这是通过越来越多地运用个人的临床技能,并从提供被动护理转变为致力于提高老年人在日常活动中的参与度来实现的。从事康复工作也带来了挑战。这与健康专业人员所感受到的一些老年人对家庭护理的期望有关,并引发了矛盾心理。

对实践的启示

护士和医护人员应关注老年人的资源和目标,以便提供能够增强日常活动参与度的服务。

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