J Hosp Palliat Nurs. 2022 Aug 1;24(4):232-239. doi: 10.1097/NJH.0000000000000870. Epub 2022 May 5.
This preliminary qualitative study aimed to explore affordable housing specialists' perceptions of challenges and patterns of advance care planning behaviors among low-income older residents in affordable housing. Advance care planning rates among such residents are disproportionally lower than higher-income older adults. Individual telephone interviews were conducted with affordable housing specialists in a major urban area in the Southeastern United States (N = 5). Using thematic content analysis, 2 independent coders synthesized the 2 coding sets into a single codebook that was iteratively and individually reapplied to the transcripts. The Ecological Model of Active Living, a model that embeds individual behavior within a physical and social environment, was used to categorize prominent codes to visualize relationships among codes and create a cohesive, ecological picture of planning behavior in this population. Four themes emerged from the data and were plotted in an adapted ecological model. Residents' ongoing struggles despite obtaining housing prevent self-initiation and maintenance of advance care planning. Housing specialists possess the expertise and empathy to guide change efforts and provide advance care planning, but aid is required to ensure adequate resources to prevent role conflict and burnout. Recommendations for interprofessional collaboration, practice, policy, and research are discussed.
本初步定性研究旨在探讨经济适用房专家对经济适用房中低收入老年居民的预先护理计划行为的挑战和模式的看法。此类居民的预先护理计划率明显低于高收入老年人。在东南部美国一个主要城市的经济适用房专家进行了个人电话访谈（N=5）。使用主题内容分析，2 位独立的编码员将 2 组编码综合到一个单一的编码本中，该编码本被迭代地并单独应用于转录本。积极生活的生态模式，该模式将个体行为嵌入物理和社会环境中，用于对突出的代码进行分类，以可视化代码之间的关系，并为该人群的规划行为创建一个有凝聚力的、生态的图景。从数据中得出了四个主题，并在一个经过改编的生态模型中进行了绘制。尽管居民获得了住房，但他们仍在持续挣扎，这阻碍了预先护理计划的自我启动和维持。住房专家拥有指导变革努力和提供预先护理计划的专业知识和同情心，但需要帮助来确保充足的资源，以防止角色冲突和倦怠。讨论了跨专业合作、实践、政策和研究的建议。
