Tennant Ryan, Allana Sana, Mercer Kate, Burns Catherine M
Department of Systems Design Engineering, Faculty of Engineering, University of Waterloo, Waterloo, ON, Canada.
Library, University of Waterloo, Waterloo, ON, Canada.
JMIR Form Res. 2024 Jul 4;8:e53289. doi: 10.2196/53289.
The demand for complex home care is increasing with the growing aging population and the ongoing COVID-19 pandemic. Family and hired caregivers play a critical role in providing care for individuals with complex home care needs. However, there are significant gaps in research informing the design of complex home care technologies that consider the experiences of family and hired caregivers collectively.
The objective of this study was to explore the health documentation and communication experiences of family and hired caregivers to inform the design and adoption of new technologies for complex home care.
The research involved semistructured interviews with 15 caregivers, including family and hired caregivers, each of whom was caring for an older adult with complex medical needs in their home in Ontario, Canada. Due to COVID-19-related protection measures, the interviews were conducted via Teams (Microsoft Corp). The interview guide was informed by the cognitive work analysis framework, and the interview was conducted using storytelling principles of narrative medicine to enhance knowledge. Inductive thematic analysis was used to code the data and develop themes.
Three main themes were developed. The first theme described how participants were continually updating the caregiver team, which captured how health information, including their communication motivations and intentions, was shared among family and hired caregiver participants. The subthemes included binder-based health documentation, digital health documentation, and communication practices beyond the binder. The second theme described how participants were learning to improve care and decision-making, which captured how they acted on information from various sources to provide care. The subthemes included developing expertise as a family caregiver and tailoring expertise as a hired caregiver. The third theme described how participants experienced conflicts within caregiver teams, which captured the different struggles arising from, and the causes of, breakdowns in communication and coordination between family and hired caregiver participants. The subthemes included 2-way communication and trusting the caregiver team.
This study highlights the health information communication and coordination challenges and experiences that family and hired caregivers face in complex home care settings for older adults. Given the challenges of this work domain, there is an opportunity for appropriate digital technology design to improve complex home care. When designing complex home care technologies, it will be critical to include the overlapping and disparate perspectives of family and hired caregivers collectively providing home care for older adults with complex needs to support all caregivers in their vital roles.
随着人口老龄化加剧以及新冠疫情持续，对复杂家庭护理的需求不断增加。家庭护理人员和雇佣护理人员在为有复杂家庭护理需求的个人提供护理方面发挥着关键作用。然而，在研究如何设计考虑家庭护理人员和雇佣护理人员共同经验的复杂家庭护理技术方面，仍存在重大差距。
本研究的目的是探索家庭护理人员和雇佣护理人员的健康记录与沟通经验，以为复杂家庭护理新技术的设计与采用提供参考。
该研究对15名护理人员进行了半结构化访谈，其中包括家庭护理人员和雇佣护理人员，他们均在加拿大安大略省家中照顾有复杂医疗需求的老年人。由于新冠疫情相关的防护措施，访谈通过Teams（微软公司）进行。访谈指南基于认知工作分析框架制定，访谈采用叙事医学的故事讲述原则进行，以增进知识。采用归纳主题分析法对数据进行编码并提炼主题。
形成了三个主要主题。第一个主题描述了参与者如何不断更新护理团队，这涵盖了健康信息（包括他们的沟通动机和意图）在家庭护理人员和雇佣护理人员参与者之间的共享方式。子主题包括基于活页夹的健康记录、数字健康记录以及活页夹之外的沟通实践。第二个主题描述了参与者如何学习改善护理和决策，这涵盖了他们如何根据来自各种来源的信息采取行动以提供护理。子主题包括作为家庭护理人员发展专业知识以及作为雇佣护理人员量身定制专业知识。第三个主题描述了参与者在护理团队中如何经历冲突，这涵盖了家庭护理人员和雇佣护理人员参与者之间沟通与协调破裂所产生的不同困难及其原因。子主题包括双向沟通和信任护理团队。
本研究凸显了家庭护理人员和雇佣护理人员在为老年人提供复杂家庭护理时所面临的健康信息沟通与协调挑战及经验。鉴于该工作领域的挑战，有机会通过适当的数字技术设计来改善复杂家庭护理。在设计复杂家庭护理技术时，将家庭护理人员和雇佣护理人员为有复杂需求的老年人共同提供家庭护理的重叠且不同的观点纳入其中至关重要，以便支持所有护理人员发挥其重要作用。
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