"It's Like They Forget That the Word 'Health' Is in 'Home Health Aide'": Understanding the Perspectives of Home Care Workers Who Care for Adults With Heart Failure
"It's Like They Forget That the Word 'Health' Is in 'Home Health Aide'": Understanding the Perspectives of Home Care Workers Who Care for Adults With Heart Failure
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DOI：
10.1161/jaha.118.010134
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发表时间：
2018-12-04
影响因子：
5.4
通讯作者：
Safford, Monika M.
中科院分区：
文献类型：
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作者：
Sterling, Madeline R.;Silva, Ariel F.;Safford, Monika M.
家庭护理人员（HCWs）越来越多地为社区居住的心力衰竭（HF）成人提供长期和住院后护理。他们观察、协助和建议这些患者，但很少有研究探讨他们在HF中的作用。作为未来干预措施的基础，我们试图了解HCWs的角度照顾成人HF.Methods和结果，我们进行了8个重点小组的合作伙伴关系与家庭护理行业教育基金，福利基金的1199服务员工国际工会联合医疗保健工作者东，最大的医疗保健联盟在美国。讲英语和西班牙语的HCW与HF客户有资格参加。按主题分析数据。由21个独特的家庭护理机构雇用的46名HCW参加了研究。出现了一般性主题和针对高频的主题。一般来说，HCW（1）感到过度劳累和被低估;（2）发现沟通和照顾是分散的;（3）致力于客户和家庭，但夹在中间;而且，尽管如此，（4）热爱他们的工作。关于HF，HCWs（1）发现它可怕的和不可预测的;（2）参与HF自我护理没有任何HF培训;和（3）发现护理计划probleming. Conclusions，虽然经常参与HF自我护理，大多数HCWs没有接受HF培训。此外，许多人感到其他医疗服务提供者和护理计划的支持很差，特别是当他们的客户症状恶化时。提供HF特定培训并旨在改善家庭医疗保健团队成员之间沟通的干预措施可能会增强HCW护理HF成人的能力，并可能导致更好的患者结局。
Background-Home care workers (HCWs) increasingly provide long-term and posthospitalization care for community-dwelling adults with heart failure (HF). They observe, assist, and advise these patients, yet few studies have examined their role in HF. As the foundation for future interventions, we sought to understand the perspectives of HCWs caring for adults with HF.Methods and Results-We conducted 8 focus groups in partnership with the Home Care Industry Education Fund, a benefit fund of the 1199 Service Employees International Union United Healthcare Workers East, the largest healthcare union in the United States. English-and Spanish-speaking HCWs with HF clients were eligible to participate. Data were analyzed thematically. Forty-six HCWs employed by 21 unique home care agencies participated. General and HF-specific themes emerged. Generally, HCWs (1) feel overworked and undervalued; (2) find communication and care to be fragmented; (3) are dedicated to clients and families but are caught in the middle; and, despite this, (4) love their job. With respect to HF, HCWs (1) find it frightening and unpredictable; (2) are involved in HF self-care without any HF training; and (3) find the care plan problematic.Conclusions-Although frequently involved in HF self-care, most HCWs have not received HF training. In addition, many felt poorly supported by other healthcare providers and the care plan, especially when their clients' symptoms worsened. Interventions that provide HF-specific training and aim to improve communication between members of the home health care team may enhance HCWs' ability to care for adults with HF and potentially lead to better patient outcomes.