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为中国城市老年人提供基于互联网的家庭护理服务的障碍:服务提供者的定性研究。

Barriers to providing internet-based home care services for urban older adults in China: a qualitative study of the service providers.

机构信息

Department of social work, Shandong University, Jinan, China.

Department of labor and social security, Jilin University, Qianjin Street 2699, Changchun, China.

出版信息

BMC Geriatr. 2023 May 23;23(1):320. doi: 10.1186/s12877-023-04028-4.

Abstract

BACKGROUND

Due to the increasingly aging population in China and the changes in social and family structure, older adults' care problems are becoming more and more prominent. To meet the home care needs of urban older adults, the Chinese government has launched Internet-Based Home Care Services (IBHCS). Although this model innovation can significantly relieve care problems, more and more evidence shows that there are many barriers in the process of IBHCS supply. The current literature is mostly from the perspective of the service users, and there are very few studies on the experience of service providers.

METHODS

In this study, we took a qualitative phenomenological approach and used semi-structured interviews to investigate service providers' daily experiences and the barriers they encounter. A total of 34 staff from 14 Home Care Service Centers (HCSCs) were included. Interviews were transcribed and analyzed using thematic analysis.

RESULTS

We identified the barriers that service providers encounter in IBHCS supply: (1) bureaucratic repression: unreasonable policy plans, harsh assessment, excessive paperwork, different preferences of government leaders, and obstacles caused by COVID-19 control lead to a shift of focus in their work; (2) profitability crisis in the market: high service costs, dampened effective demand, government intervention in setting prices, and parent companies' excessively high sales targets hinder the service supply process; (3) client-related challenges: the crisis of confidence, the dilemma of popularizing new technology, and communication barriers lead to rejection by older adults; (4) job dissatisfaction: low and unstable salary, heavy tasks, poor social acceptance of occupations, and lack of professional value reduce work enthusiasm.

CONCLUSION

We have investigated the barriers faced by service providers when providing IBHCS for urban older adults in China, providing empirical evidence in the Chinese context for the relevant literature. In order to provide IBHCS better, it is necessary to improve the institutional environment and market environment, strengthen publicity and communication, target customer needs, and adjust the working conditions of front-line workers.

摘要

背景

由于中国人口老龄化日益加剧,以及社会和家庭结构的变化,老年人的护理问题越来越突出。为满足城市老年人的居家护理需求,中国政府推出了基于互联网的居家护理服务(IBHCS)。虽然这种模式创新可以显著缓解护理问题,但越来越多的证据表明,IBHCS 供应过程中存在诸多障碍。目前的文献大多来自服务使用者的角度,很少有研究关注服务提供者的体验。

方法

在这项研究中,我们采用了定性现象学方法,通过半结构化访谈调查了服务提供者的日常体验和他们所遇到的障碍。共纳入了来自 14 家居家护理服务中心(HCSC)的 34 名工作人员。访谈内容转录后采用主题分析法进行分析。

结果

我们确定了服务提供者在 IBHCS 供应中遇到的障碍:(1)官僚压制:不合理的政策规划、苛刻的评估、过多的文书工作、政府领导偏好的不同以及新冠疫情防控带来的障碍导致他们的工作重点发生转移;(2)市场盈利危机:服务成本高、有效需求低迷、政府干预定价以及母公司过高的销售目标阻碍了服务供应过程;(3)客户相关挑战:信任危机、新技术推广的困境以及沟通障碍导致老年人的拒绝;(4)工作不满:工资低且不稳定、任务繁重、职业社会认可度低以及缺乏专业价值感降低了工作积极性。

结论

我们调查了中国城市老年人提供 IBHCS 的服务提供者所面临的障碍,为相关文献提供了中国背景下的经验证据。为了更好地提供 IBHCS,有必要改善制度环境和市场环境,加强宣传和沟通,满足客户需求,并调整一线工作人员的工作条件。

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