Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Sinai Health, Toronto, Canada.
PLoS One. 2022 Sep 13;17(9):e0274269. doi: 10.1371/journal.pone.0274269. eCollection 2022.
Accelerating rates of dementia worldwide coupled with older adults living longer in the community calls for greater focus on quality home care support services. Few frameworks for quality dementia home care exist though prior findings have found elements considered to be important for "good" home care for people living with dementia. This study aimed to identify core components of a quality home care experience for people with dementia and their caregivers.
As part of a larger research study, in-depth interviews were conducted with persons living with dementia and caregivers (n = 25) to explore hospital-to-home care transitions. The design used for this study was a qualitative description. We used deductive-inductive thematic analysis, which was informed by previous work in this area. Open codes were mapped to pre-determined themes, and for codes not accommodated by an a piori framework, new themes were developed.
Our findings resulted in 4 overarching themes. Two themes were identified deductively (Availability and Acceptability of Home Care Services) and two inductively (Adaptability and Affordability of Home Care Services). Findings highlight the roles of family-care provider partnerships and responsive support in receiving quality home care, and the cost associated with unmet needs.
With an aging population, an increase in home care client acuity, and post-COVID-19 concerns over long-term care, more attention is needed to improve the quality of home care. The demand for these services will continue to increase particularly for those living with dementia and their families. The findings of availability, acceptability, adaptability, and affordability as core to quality care can help lay the groundwork for a home care framework for persons living with dementia and their caregivers. Future research could benefit from comparative analyses to evaluate the applicability of the findings to non-dementia home care service users and caregivers.
全球痴呆症发病率的加速上升，加上老年人在社区中寿命的延长，这就要求更加关注高质量的家庭护理支持服务。尽管之前的研究已经发现了一些被认为对痴呆症患者家庭护理“有益”的因素，但针对高质量痴呆症家庭护理的框架很少。本研究旨在确定痴呆症患者及其护理人员优质家庭护理体验的核心要素。
作为一项更大的研究的一部分，对 25 名患有痴呆症的患者及其护理人员进行了深入访谈，以探讨从医院到家庭的护理过渡。本研究采用定性描述设计。我们使用了演绎归纳主题分析，这是基于该领域的先前工作。开放代码被映射到预先确定的主题，对于无法用先验框架容纳的代码，开发了新的主题。
我们的研究结果产生了 4 个总体主题。两个主题是演绎性的（家庭护理服务的可用性和可接受性），两个是归纳性的（家庭护理服务的适应性和负担能力）。研究结果强调了家庭护理提供者伙伴关系和响应性支持在获得高质量家庭护理方面的作用，以及未满足需求所带来的成本。
随着人口老龄化、家庭护理客户病情加重以及 COVID-19 后对长期护理的担忧，需要更多关注来提高家庭护理的质量。对这些服务的需求将继续增加，特别是对那些患有痴呆症的患者及其家庭。将可用性、可接受性、适应性和负担能力作为优质护理的核心要素，可以为痴呆症患者及其护理人员的家庭护理框架奠定基础。未来的研究可以从比较分析中受益，以评估这些发现对非痴呆症家庭护理服务使用者和护理人员的适用性。
