The indispensable intermediaries: a qualitative study of informal caregivers' struggle to achieve influence at and after hospital discharge.
The indispensable intermediaries: a qualitative study of informal caregivers' struggle to achieve influence at and after hospital discharge.
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DOI：
10.1186/1472-6963-14-331
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发表时间：
2014-07-30
影响因子：
2.8
通讯作者：
Foss C
中科院分区：
文献类型：
--
作者：
Bragstad LK;Kirkevold M;Foss C
护理政策以及护理行业的组织架构正在发生转变，以适应预期的人口结构变化，并确保未来医疗保健服务提供模式的可持续性。当老年人身体机能下降导致护理需求增加时，成年子女和配偶往往首先承担起照顾责任。通过出台相关政策，使家庭成员能够在从事有薪工作的同时照顾老年亲属，挪威未来老年人护理的可持续性比以往更加明确地依赖于家庭和非正式护理人员。护理对象和非正式护理人员应发挥积极的消费者作用，参与护理决策过程。本文旨在描述非正式护理人员在为居家老年亲属安排出院时及出院后的护理决策过程中的相关经历。
本文报告了一项探索性定性设计的后续研究结果。对挪威19名老年出院患者的非正式护理人员进行了定性电话访谈，并进行了归纳式主题内容分析。
非正式护理人员作为护理对象和医疗保健服务之间的中间人，承担着全面且耗费精力的角色。从本质上讲，非正式护理人员代表其老年亲属扮演积极参与者的角色。他们描述了为与医疗保健服务的“把关者”建立对话所付出的巨大努力。为护理对象实现尽可能好的护理目标似乎取决于非正式护理人员是否有资源选择合适的策略来对决策施加影响。
护理对象身体极度虚弱且对家庭的依赖日益增加，再加上医疗保健服务的复杂性，使得非正式护理人员作为中间人的不可或缺的作用更加凸显。这些发现强调了有必要进一步探讨如何支持体弱的老年人及其非正式护理人员，使其能够参与有关满足护理对象需求的护理安排的决策。
The care policy and organization of the care sector is shifting to accommodate projected demographic changes and to ensure a sustainable model of health care provision in the future. Adult children and spouses are often the first to assume care giving responsibilities for older adults when declining function results in increased care needs. By introducing policies tailored to enabling family members to combine gainful employment with providing care for older relatives, the sustainability of the future care for older individuals in Norway is more explicitly placed on the family and informal caregivers than previously. Care recipients and informal caregivers are expected to take an active consumer role and participate in the care decision-making process. This paper aims to describe the informal caregivers’ experiences of influencing decision-making at and after hospital discharge for home-bound older relatives. This paper reports findings from a follow-up study with an exploratory qualitative design. Qualitative telephone interviews were conducted with 19 informal caregivers of older individuals discharged from hospital in Norway. An inductive thematic content analysis was undertaken. Informal caregivers take on comprehensive all-consuming roles as intermediaries between the care recipient and the health care services. In essence, the informal caregivers take the role of the active participant on behalf of their older relative. They describe extensive efforts struggling to establish dialogues with the “gatekeepers” of the health care services. Achieving the goal of the best possible care for the care recipient seem to depend on the informal caregivers having the resources to choose appropriate strategies for gaining influence over decisions. The care recipients’ extensive frailty and increasing dependence on their families coupled with the complexity of health care services contribute to the perception of the informal caregivers’ indispensable role as intermediaries. These findings accentuate the need to further discuss how frail older individuals and their informal caregivers can be supported and enabled to participate in decision-making regarding care arrangements that meet the care recipient’s needs.
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影响因子：
3.5
作者：
Foss, Christina;Hofoss, Dag
通讯作者：
Hofoss, Dag
影响因子：
3.8
作者：
Aasen, Elin Margrethe;Kvangarsnes, Marit;Heggen, Kare
通讯作者：
Heggen, Kare
影响因子：
1.9
作者：
Duner, Anna
通讯作者：
Duner, Anna
影响因子：
5.4
作者：
Clayman, ML;Roter, D;Bandeen-Roche, K
通讯作者：
Bandeen-Roche, K
影响因子：
2.3
作者：
Bjornsdottir, Kristin
通讯作者：
Bjornsdottir, Kristin