Hengelaar Aldiene Henrieke, van Hartingsveldt Margo, Abma Tineke, Verdonk Petra
Department Ethics, Law and Humanities, Amsterdam Public Health Research Institute, Amsterdam University of Applied Science, Amsterdam UMC, location VUmc, Tafelbergweg 51, PO box 2557, 1000 CN, Amsterdam, The Netherlands.
Department of Occupational Therapy, Amsterdam University of Applied Science, Amsterdam, The Netherlands.
Health Care Anal. 2025 Jan 3. doi: 10.1007/s10728-024-00504-z.
In many western countries informal care is conceived as the answer to the increasing care demand. Little is known how formal and informal caregivers collaborate in the context of an diverse ageing population. The aim of this study was to gain insight in how professionals' perspectives regarding the collaboration with informal carers with a migration background are framed and shaped by intersecting aspects of diversity. We used an intersectionality informed qualitative design with informal conversations (N = 12) and semi-structured interviews (N = 17) with healthcare professionals working with clients with Acquired Brain Injury. Two critical friends were involved in the analysis which was substantiated by a participatory analysis with a community of practice. We identified four interrelated themes: (a) 'The difficult Other' in which professionals reflected on carers with a migration background causing 'difficulties'; (b) 'The dependent Other' refers to professionals' realization that 'difficulties' are intensified by the context in which care takes place; (c) in 'The uncomfortable self' professionals describe how feelings of insecurities evoked by the Other are associated with an inability to act 'professionally', and; (d) 'The reflexive self' shows how some professionals reflect on their own identities and identify their blind spots in collaboration within a care network. These themes demonstrate the tensions, biases and power imbalances between carers and professionals, which may explain some of the existing health disparities perpetuated through care networks.
在许多西方国家，非正式照护被视为应对日益增长的照护需求的答案。对于在多样化的老龄人口背景下，正式照护者和非正式照护者如何协作，我们知之甚少。本研究的目的是深入了解与具有移民背景的非正式照护者协作时，专业人员的观点是如何受到多样性的交叉因素的构建和塑造的。我们采用了一种基于交叉性的定性设计，对与患有后天性脑损伤的客户打交道的医疗保健专业人员进行了非正式交谈（N = 12）和半结构化访谈（N = 17）。两名关键伙伴参与了分析，该分析得到了一个实践社区的参与式分析的证实。我们确定了四个相互关联的主题：（a）“棘手的他者”，其中专业人员反思了具有移民背景的照护者带来的“困难”；（b）“依赖的他者”指专业人员认识到照护发生的背景加剧了“困难”；（c）在“不安的自我”中，专业人员描述了被他者唤起的不安全感如何与无法“专业地”行事相关联，以及；（d）“反思的自我”展示了一些专业人员如何反思自己的身份，并在照护网络内的协作中识别出自己的盲点。这些主题揭示了照护者与专业人员之间的紧张关系、偏见和权力不平衡，这可能解释了通过照护网络持续存在的一些现有的健康差距。
