Faculty of Health Sciences, Institute of Nursing and health promotion, Oslo Metropolitan University, Postbox 4, St. Olavs plass, N-0130, Oslo, Norway.
Faculty of Health and Sport Sciences, Institute of Health and Nursing Science, University of Agder, Postboks 422, N-4604, Kristiansand, Norway.
BMC Geriatr. 2022 Mar 18;22(1):223. doi: 10.1186/s12877-022-02890-2.
Demographic, economic and organisational changes challenge home care services. Increased use of welfare technology and involvement of family members as co-producers of care are political initiatives to meet these challenges. However, these initiatives also involve ethical aspects.
The aim of this qualitative study was to explore family caregivers' experience of involvement and possible ethical aspects of caring for frail older family members receiving home care services supported by welfare technology. This study used a qualitative explorative and descriptive design within a phenomenological-hermeneutical approach. Sixteen interviews with eighteen family caregivers were conducted. The participants were sons, daughters, siblings and spouses of frail older people receiving home care services with the support of welfare technology. Data were analysed using reflexive thematic analysis. The COREQ checklist was used.
The analysis led to five main themes. First, the family caregivers' experienced caring as meaningful but increasingly demanding concerning the changes in home care services. Second, they experienced a change in relationships, roles, tasks, and responsibilities related to more family involvement and the use of welfare technology. This also challenged their sense of autonomy. However, welfare technology helped them deal with responsibilities, especially safety. The family caregivers requested early involvement, dialogue for care decisions, more cooperation and support from health professionals. Third, the participants experienced that health professionals decided the conditions for co-production without discussion. Their need for information and knowledge about welfare technology were not met. Fourth, the family caregivers felt that the health professionals did not adequately recognise their unique knowledge of the care receiver and did not use this knowledge for customising the welfare technology to the care receiver and their families. Fifth, the family caregivers expressed concern about service and welfare technology inequality in home care services.
Co-production in the involvement of family caregivers in care is still not an integral part of home care service. Welfare technology was appreciated, but the family caregivers called for early involvement to ensure successful and safe implementation and use. More attention needs to be given to ethical concerns about the change in relations, transfer of tasks and responsibility, and risk of inequality.
人口结构、经济和组织方面的变化给家庭护理服务带来了挑战。增加福利技术的使用和让家庭成员作为共同生产者参与护理是应对这些挑战的政治举措。然而，这些举措也涉及到伦理方面。
本研究旨在探讨家庭护理员在参与照顾接受福利技术支持的家庭护理服务的体弱老年人方面的经验以及可能存在的伦理问题。本研究采用了在现象学解释学方法内的定性探索性和描述性设计。对 18 名接受福利技术支持的家庭护理服务的体弱老年人的子女、兄弟姐妹和配偶进行了 16 次访谈。数据分析采用反思性主题分析。使用 COREQ 清单。
分析产生了五个主要主题。首先，家庭护理员认为照顾是有意义的，但由于家庭护理服务的变化，照顾的需求越来越大。其次，他们经历了关系、角色、任务和责任的变化，这与更多的家庭参与和福利技术的使用有关，这也挑战了他们的自主权。然而，福利技术帮助他们应对责任，特别是安全责任。家庭护理员要求尽早参与、共同制定护理决策、更多的合作和来自卫生专业人员的支持。第三，参与者体验到卫生专业人员在没有讨论的情况下决定共同生产的条件。他们对福利技术的信息和知识的需求没有得到满足。第四，家庭护理员感到卫生专业人员没有充分认识到他们对护理接受者的独特知识，也没有将这种知识用于根据护理接受者及其家庭的情况定制福利技术。第五，家庭护理员对家庭护理服务中服务和福利技术不平等表示关注。
家庭护理员参与护理的共同生产仍然不是家庭护理服务的一个组成部分。福利技术受到了赞赏，但家庭护理员呼吁尽早参与，以确保成功和安全的实施和使用。需要更多地关注关系变化、任务和责任转移以及不平等风险方面的伦理问题。
