“照护工作就像是在职培训，但却没有人有操作手册”：加拿大照护者对其在医疗体系中角色的看法。
"Caregiving is like on the job training but nobody has the manual": Canadian caregivers' perceptions of their roles within the healthcare system.
机构信息
Trillium Health Partners - Institute for Better Health, 100 Queensway West, 6th Floor CA Building, Mississauga, ON, L5B 1B8, Canada.
University of Toronto - Institute for Health Policy, Management and Evaluation, 155 College Street, 4th Floor, Toronto, ON, M5T 3M6, Canada.
出版信息
BMC Geriatr. 2021 Jun 30;21(1):404. doi: 10.1186/s12877-021-02354-z.
BACKGROUND
Stepping into the role of an unpaid caregiver to offer help is often considered a natural expectation of family members or friends. In Canada, such contributions are substantial in terms of healthcare provision but this comes at a considerable cost to the caregivers in both health and economic terms.
METHODS
In this study, we conducted a secondary analysis of a collection of qualitative interviews with 39 caregivers of people with chronic physical illness to assess how they described their particular roles in caring for a loved one. We used a model of caregiving roles, originally proposed by Twigg in 1989, as a guide for our analysis, which specified three predominant roles for caregivers - as a resource, as a co-worker, and as a co-client.
RESULTS
The caregivers in this collection spoke about their roles in ways that aligned well with these roles, but they also described tasks and activities that fit best with a fourth role of 'care-coordinator', which required that they assume an oversight role in coordinating care across institutions, care providers and often advocate for care in line with their expectations. For each of these types of roles, we have highlighted the limitations and challenges they described in their interviews.
CONCLUSIONS
We argue that a deeper understanding of the different roles that caregivers assume, as well as their challenges, can contribute to the design and implementation of policies and services that would support their contributions and choices as integral members of the care team. We provide some examples of system-level policies and programs from different jurisdictions developed in recognition of the need to sustain caregivers in their role and respond to such limitations.
背景
作为非付费护理人员提供帮助通常被视为家庭成员或朋友的自然期望。在加拿大，从医疗保健提供的角度来看，这种贡献是巨大的，但这对护理人员的健康和经济都造成了相当大的代价。
方法
在这项研究中，我们对 39 名照顾慢性身体疾病患者的护理人员的定性访谈进行了二次分析，以评估他们如何描述自己在照顾亲人方面的特定角色。我们使用了 Twigg 于 1989 年提出的护理角色模型作为我们分析的指导，该模型指定了护理人员的三个主要角色 - 作为资源、作为同事和作为共同客户。
结果
本研究中的护理人员以与这些角色相一致的方式描述了他们的角色，但他们也描述了最适合“护理协调员”角色的任务和活动，这需要他们承担协调机构间、护理提供者的护理工作的监督角色，并且通常根据他们的期望为护理工作辩护。对于每种类型的角色，我们都强调了他们在访谈中描述的局限性和挑战。
结论
我们认为，更深入地了解护理人员承担的不同角色及其挑战，可以为政策和服务的设计和实施做出贡献，这些政策和服务将支持他们作为护理团队不可或缺的成员的贡献和选择。我们提供了一些来自不同司法管辖区的系统层面政策和计划的例子，这些政策和计划是为了认识到需要维持护理人员在其角色中的地位并应对这些限制而制定的。
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