How do clients and (In)formal caregivers experience quality of home care? A qualitative approach

J Adv Nurs. 2020 Jan;76(1):264-274. doi: 10.1111/jan.14234. Epub 2019 Nov 6.

Abstract

Aim: To explore and understand the views of clients and formal and informal caregivers about the experienced quality of home care for older people.

Design: A descriptive qualitative study was conducted using individual interviews.

Methods: Six home care clients, four formal and six informal caregivers were recruited from two Dutch home care organizations. Individual, semi-structured interviews took place between April - November 2018. The INDividually EXperienced QUAlity of Long-term care framework was used to guide data collection and content analyses.

Results: The analyses revealed several important attributes contributing to experienced quality of home care such as a preferred small number of caregivers, perceived sufficient time for care provision and a caring atmosphere facilitating open communication and humour. Participants indicated that care routines fitting with the care receiver's former way of living were important. A more 'close' personal care relationship related to trust, openness and empathy was preferred over a more 'detached' professional care relationship.

Conclusion: This study identified a wide range of attributes related to experienced quality of care from the perspectives of clients and formal and informal caregivers in home care.

Impact: Care providers are being challenged to structurally assess individual experienced quality of home care. This study underlines the importance of incorporating care preferences and experiences throughout the care process from a relationship-centred care approach. Relevant care measures and outcomes should be determined to gain insight and further improve individual care provision.

目的: 探讨和了解客户和正式和非正式护理人员对老年人体验居家护理的质量的看法。 设计: 采用个体访谈进行描述性定性研究。 方法: 从荷兰两家家庭护理机构招募了6名家庭护理接受客户、4名正式护理人员和6名非正式护理人员。在2018年4月至11月期间对每个人进行了个人半结构化访谈。长期护理框架的个人体验质量被用来指导数据收集和内容分析。 结果: 分析揭示了影响居家护理质量的几个重要因素,如首选看护者数量较少、有充足的看护时间、有利于开放交流和幽默的关怀氛围。参与者还表示护理程序符合接受照顾人以前的生活方式很重要。一种更“亲密”的富有信任、率真和同情心的个人护理关系比“分离”式的专业护理关系更好。 结论: 本研究从病人和家庭护理中正式和非正式护理人员的角度确定了与护理质量相关的一系列属性。 影响: 护理提供者正面临着从结构上评估家庭护理个人体验质量的挑战。此研究的重点在于强调将以关系为中心的护理方法中的看护偏好和经验融入整个护理过程的重要性。应确定相关的护理措施和结果,以深入了解并进一步改善个人护理。.

Keywords: care relationship; experienced quality; home care; nursing; older people; quality of care; relationship-centred care.

MeSH terms

  • Caregivers / psychology*
  • Home Care Services / standards*
  • Humans
  • Interviews as Topic
  • Netherlands
  • Patient Satisfaction
  • Patients / psychology*
  • Qualitative Research