What happens during the transition from informal to formal homecare for a person living with dementia? An exploratory qualitative study.

苏格兰患有痴呆症的人数正在增加，目前估计为90,684人。近年来，残疾人士由住家照顾转为在家照顾，令社区对非正式（无薪）和正式（有薪）照顾的需求增加，而大部分在家照顾由非正式照顾者提供。然而，对残疾人士的非正式照顾有充分的记录，因为压力大，支持水平低，可能对残疾人士的健康构成风险。当非正式照护者得不到足够的支持时，也有残疾人士被早期收容的风险。过渡时期被广泛定义为一个人生活中的一段变化时期。有证据表明，过渡增加了残疾患者非正式照料者的压力和负担。拟议研究的总体目标是从促进和抑制因素的角度理解家庭非正规护理和正规护理之间的过渡时期，包括三个研究问题：问题1：“如何描述过渡时期非正规护理和正规护理人员的经历？”其目的是从促进和抑制因素的角度来描述这种转变，并探讨对身份、角色和转变本身等概念的看法。问题2：“社会因素（如社区网络、教育水平、护理经验）与过渡经验之间是否存在模式？”它旨在调查环境对经验的影响。问题3：“对转型的看法会随着时间的推移而改变吗？”这是一个纵向的问题，提供了反思的机会，并将产生对过渡影响的潜在寿命的见解。拟议的定性探索性研究将分三个连续阶段进行：完成范围审查的探索性阶段、描述性横断面阶段和反思性纵向阶段。

The number of people living with dementia (PWD) in Scotland is increasing and is currently estimated at 90,684 people. In recent years, a shift from residential care to care in the home for PWD has created increased demand for informal (unpaid) and formal (paid) caregiving in the community, with the majority of care at home being attended to by informal caregivers. However, informal caregiving for PWD is well documented as stressful and poor levels of support can pose a risk to the health of. When informal caregivers receive insufficient support there is also a risk of early institutionalisation for PWD. Transition is broadly defined as a period of change in a person's life. Evidence suggests that transitions increase stress and burden for informal caregivers of PWD.The overarching aim of the proposed research is to understand the period of transition between informal and formal care at home in terms of facilitating and inhibiting factors, incorporating three research questions:Question 1: "How can the experience of informal and formal caregivers, during the period of transition, be described?" The purpose of which is to describe the transition in terms of facilitating and inhibiting factors, and to explore perceptions of concepts such as identity, role, and transition itself.Question 2: "Are there patterns between social factors - such as community networks, level of education, caregiving experience - and experience of the transition?" Which seeks to investigate the impact of context on experience.Question 3: "Do perceptions of the transition change over time?" A longitudinal question that affords opportunity for reflection, and will generate insight into the potential longevity of the impact of the transition.The proposed qualitative exploratory research will take place over 3 sequential phases: An exploratory phase whereby a scoping review will be completed, a descriptive cross-sectional phase and a reflective longitudinal phase.