Nova Scotia Centre on Aging, Mount Saint Vincent University, Halifax, NS, Canada.
Teaching and Learning Department, Contestoga College, Kitchener ON, Canada.
J Appl Gerontol. 2024 Jan;43(1):101-109. doi: 10.1177/07334648231201837. Epub 2023 Oct 6.
More research is needed into how "person-centered care" (PCC) manifests in home care (HC) worker-client relationships. Qualitative data were collected at three time points from twelve HC workers and others to better understand how approaches to care shape the pathways of older adult HC clients with chronic conditions in two Canadian health jurisdictions. This paper uses critical disability and intersectionality frameworks to highlight ways in which PCC enables social and instrumental benefits for workers' and clients. It also exposes difficulties in being flexible and developing interpersonal relationships because of HC policies. Workers also acknowledged risks when trying to prioritize client preferences, sometimes drawing distinctions between reasonable and unreasonable demands. Implications for enhanced training and support for workers around navigating flexibility and boundaries and using a relational approach to PCC are discussed, as are implications for policy-making that protect all parties.
需要进一步研究“以患者为中心的护理”(PCC)在家庭护理(HC)工作者与患者关系中的体现。本研究从定性的角度,在三个时间点从 12 名 HC 工作者和其他人员收集数据,以更好地了解在加拿大两个卫生管辖区中,各种护理方法如何影响患有慢性病的老年 HC 患者的护理路径。本文使用批判残疾和交叉性框架来突出 PCC 为工作者和患者带来的社会和工具性利益的方式。它还揭示了 HC 政策下工作者在灵活调整和发展人际关系方面所面临的困难。工作者还承认,在努力优先考虑患者偏好时存在风险,有时会在合理和不合理需求之间做出区分。本文讨论了为工作者提供强化培训和支持以帮助他们灵活调整和设定界限以及采用关系方法来实现 PCC 的意义,还讨论了为保护各方利益制定政策的意义。