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从伊朗非正规照护者的角度来看老年人居家护理的障碍:一项定性研究。

Barriers to home care for older adults from perspectives of Iranian informal caregivers: a qualitative study.

机构信息

Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

出版信息

BMJ Open. 2022 Dec 7;12(12):e065547. doi: 10.1136/bmjopen-2022-065547.

Abstract

OBJECTIVE

A longer life expectancy increases the number of older adults who require long-term care. The presence of a caregiver at home prevents the placement of older adults in care facilities. Identifying the caregivers' viewpoints around the care clarifies key factors in providing quality care.This study aimed to assess barriers to home care from the perspective of Iranian informal caregivers of older adults.

DESIGN

This was a qualitative study with content analysis. Semistructured interviews were conducted via telephone in Persian with informal caregivers of older adults using open-ended questions.

SETTING

Social and health organisations in southern Tehran, Iran.

PARTICIPANTS

Seventeen informal caregivers were selected on purpose. Participants were eligible to participate in the study if they were 18 years or older, and had at least 1 month of care experience for a minimum of 6 hours per week.

RESULTS

Barriers to home care for older adults from informal caregivers' points of view were categorised into three domains: (1) Individual barriers include the physical, mental and social burden of care as well as personal characteristics of the caregiver; (2) interpersonal barriers include psychobehavioural characteristics of the older adult and misbehaviour of people around the caregiver and (3) care system barriers include inefficient institutional/organisational infrastructure, moral issues and inefficiency in public policy.

CONCLUSIONS

Our study showed multiple individual, interpersonal and care system barriers to home care for older adults. Specific contextual challenges among Iranian caregivers, such as their attitudes and beliefs, as well as a lack of social and healthcare support for families, hindered the quality of care.

TRIAL REGISTRATION NUMBER

IRCT20201012048999N1.

摘要

目的

预期寿命的延长增加了需要长期护理的老年人数量。家庭护理员的存在可以防止老年人被安置在护理机构中。了解护理员对护理的看法可以明确提供优质护理的关键因素。本研究旨在从伊朗老年人家属的角度评估家庭护理的障碍。

设计

这是一项定性研究,采用内容分析法。通过电话以波斯语对老年人家属的非正式护理员进行半结构式访谈,使用开放式问题。

地点

伊朗德黑兰南部的社会和卫生组织。

参与者

purposively 选择了 17 名非正式护理员。如果护理员年龄在 18 岁或以上,并且有至少 1 个月的每周至少 6 小时的护理经验,则有资格参加研究。

结果

从非正式护理员的角度来看,老年人家庭护理的障碍分为三个领域:(1)个人障碍包括护理的身体、心理和社会负担以及护理员的个人特征;(2)人际障碍包括老年人心理行为特征以及护理员周围人的不良行为;(3)护理系统障碍包括机构/组织基础设施效率低下、道德问题和公共政策效率低下。

结论

我们的研究表明,老年人家庭护理存在多种个人、人际和护理系统障碍。伊朗护理员存在特定的背景挑战,例如他们的态度和信念,以及家庭缺乏社会和医疗保健支持,这阻碍了护理质量。

试验注册号

IRCT20201012048999N1。

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