Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK.
NIHR Applied Research Collaboration North West Coast, Liverpool, UK.
Health Expect. 2024 Apr;27(2):e14029. doi: 10.1111/hex.14029.
The aim of this qualitative study was to explore the barriers and facilitators to accessing and receiving mental health care for paid and unpaid carers of older adults.
Unpaid and paid carers for older adults in England were interviewed remotely between May and December 2022. Participants were asked about their experiences of mental health needs and support. Reflexive thematic analysis was used to analyse the data.
Thirty-seven carers participated (n = 9; n = 28), with the majority caring for a parent with dementia. Thematic analysis generated four themes: lack of healthcare support, social care system failing to enable time off, personal barriers and unsupportive work culture. Healthcare professionals failed to provide any link to mental health services, including when a dementia diagnosis was received. Structural and organisational barriers were evidenced by carers being unable to take time off from their unpaid caring duties or paid caring role, due to an absence of social care support for their relative.
This is the first study to have explored the barriers to mental health care and support for paid and unpaid carers for older adults and suggests that structural, organisational and personal barriers cause severe difficulties in accessing required support to care for older relatives, services users and residents.
Two unpaid carers aided with the development of topic guides, data analysis, interpretation and dissemination. Both were supported and trained to code anonymised transcripts.
本定性研究旨在探讨有酬和无酬照顾老年人的护理人员在获得和接受心理健康护理方面的障碍和促进因素。
2022 年 5 月至 12 月期间,通过远程方式对英格兰的有酬和无酬老年护理人员进行了访谈。要求参与者讲述他们的心理健康需求和支持情况。采用反思性主题分析方法对数据进行分析。
37 名护理人员参与了研究(n=9;n=28),其中大多数人照顾的是患有痴呆症的父母。主题分析生成了四个主题:缺乏医疗保健支持、社会护理系统未能提供休假机会、个人障碍和不支持的工作文化。医疗保健专业人员未能提供任何与心理健康服务的联系,包括在收到痴呆症诊断时。由于其亲属缺乏社会护理支持,护理人员无法从无薪护理职责或有偿护理角色中抽出时间,这就证明了存在结构性和组织性障碍。
这是第一项探讨有酬和无酬照顾老年人的护理人员的心理健康护理和支持的障碍的研究,表明结构性、组织性和个人障碍导致他们在获得照顾老年亲属所需的支持方面遇到严重困难,包括服务使用者和居民。
两名无酬护理人员协助制定了主题指南、数据分析、解释和传播。这两人都得到了支持和培训,以对匿名转录本进行编码。