Including and Training Family Caregivers of Older Adults in Hospital Care: Facilitators and Barriers.
Journal
Journal of nursing care quality
ISSN: 1550-5065
Titre abrégé: J Nurs Care Qual
Pays: United States
ID NLM: 9200672
Informations de publication
Date de publication:
Historique:
pubmed:
20
3
2019
medline:
28
4
2020
entrez:
20
3
2019
Statut:
ppublish
Résumé
Despite the role caregivers play in the delivery of care, the interactions and training methods used with caregivers during an inpatient stay are not clear. The purpose was to examine interactions and training methods used with caregivers during hospital care. A mixed-methods case study was conducted. Observations were summarized and interviews were analyzed using thematic analysis. The frequency of caregiver engagement varied at different points in the care process but was highest among observations during the stay care point. Providers were most commonly using written and verbal instructions to train caregivers. Three themes emerged from the interviews and were described to be both facilitators and barriers to caregiver involvement: experience, time, and relationship. High-quality person and family-centered care depends upon coordinated efforts among health care systems, providers, patients, and caregivers. Future caregiver initiatives should aim to decrease disengagement, increase assessment, and broaden the use of training methods.
Sections du résumé
BACKGROUND
BACKGROUND
Despite the role caregivers play in the delivery of care, the interactions and training methods used with caregivers during an inpatient stay are not clear.
PURPOSE
OBJECTIVE
The purpose was to examine interactions and training methods used with caregivers during hospital care.
METHODS
METHODS
A mixed-methods case study was conducted. Observations were summarized and interviews were analyzed using thematic analysis.
RESULTS
RESULTS
The frequency of caregiver engagement varied at different points in the care process but was highest among observations during the stay care point. Providers were most commonly using written and verbal instructions to train caregivers. Three themes emerged from the interviews and were described to be both facilitators and barriers to caregiver involvement: experience, time, and relationship.
CONCLUSIONS
CONCLUSIONS
High-quality person and family-centered care depends upon coordinated efforts among health care systems, providers, patients, and caregivers. Future caregiver initiatives should aim to decrease disengagement, increase assessment, and broaden the use of training methods.
Identifiants
pubmed: 30889081
doi: 10.1097/NCQ.0000000000000400
pii: 00001786-202001000-00015
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
88-94Références
Congress.gov. RAISE Family Caregivers Act of 2018, S. 1028/H.R. 3759 Cong. https://www.congress.gov/bill/115th-congress/senate-bill/1028. Accessed December 13, 2018.
AARP. New state law to help family caregivers. https://www.aarp.org/politics-society/advocacy/caregiving-advocacy/info-2014/aarp-creates-model-state-bill.html. Published 2014. Accessed December 13, 2018.
Rodakowski R, Rocco PB, Ortiz M, et al. Caregiver integration during discharge planning for older adults to reduce resource use: a meta-analysis. J Am Geriatr Soc. 2017;65(8):1748–1755.
Bauer M, Fitzgerald L, Haesler E, Manfrin M. Hospital discharge planning for frail older people and their family. Are we delivering best practice? A review of the evidence. J Clin Nurs. 2009;18(18):2539–2546.
Levine C, Halper D, Peist A, Gould DA. Bridging troubled waters: family caregivers, transitions, and long-term care. Health Aff. 2010;29(1):116–124.
Institute for Patient-and Family-Centered Care. Patient-and family-centered care. http://www.ipfcc.org/about/pfcc.html. Published 2018. Accessed December 13, 2018.
Chisholm D, Boyt Schell BA. Overview of the occupational therapy process and outcomes. In: Boyt Schell BA, Gillen G, Scaffa ME, Cohn ES, eds. Willard & Spackman's Occupational Therapy. Baltimore, MD: Wolters Kluwer: Lippincott Williams & Wilkins; 2014:266–267.
Anderson N, Herriot P, Hodgkinson GP. The practitioner-researcher divide in industrial, work and organizational (IWO) psychology: where are we now, and where do we go from here? J Occup Organ Psychol. 2001;74:391–411.
Donabedian A. The quality of care. JAMA. 1988;260(12):1743.
Vosaic. Coda/Icoda. Lincoln, NE: Vosaic.
Edhlund B, McDougall A. Nvivo 10 Essentials: Your Guide to the World's Most Powerful Data Analysis Software. Stallarholmen, Sweden: Form & Kunskap AB; 2012.
Braun V, Clark V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.
Creswell J, Plano-Clark VL. Choosing a Mixed Methods Design. 2nd ed. Thousand Oaks, CA: Sage; 2011.
Plank A, Mazzoni V, Cavada L. Becoming a caregiver: new family carers' experience during the transition from hospital to home. J Clin Nurs. 2011;21(13/14):2072–2082.
Donelan K, Hill CA, Hoffman C, Scoles K, et al. Challenged to care: informal caregivers in a changing health system. Health Aff. 2002;21(4):22–231.
Gitlin LN, Schulz R. Family caregiving of older adults. In: Prohaska R, Anderson LA, Binstock RH, eds. Public Health for an Aging Society. Baltimore, MD: The Johns Hopkins University Press; 2012:181–205.
Dzau VJ, McClellan MB, McGinnis JM, et al. Vital directions for health and health care. JAMA. 2017;317(14):1461.
Fields B, Rodakowski J, James EA, Beach S. Caregiver health literacy predicting health care communication and system navigation difficulty. Fam Syst Health. 2018;36(4):482–492.
Gill A, Kuluski K, Jaakkimainen L, Naganathan G, Upshur R, Wodchis WP. Where do we go from here? Health system frustrations expressed by patients with multimorbidity, their caregivers and family physicians. Healthc Policy. 2014;9(4):73–89.
Naylor MD, Brooten D, Campbell R, et al. Comprehensive discharge planning and home follow-up of hospitalized elders: a randomized clinical trial. JAMA. 1999;281(7):613–620.
Seltzer M, Litchfield L, Kapust L, Mayer J. Professional and family collaboration in case management: a hospital-based replication of a community-based study. Soc Work Health Care. 1992;19:1–21.
Schenk EC, Bryant R, Van Son CR, Odom-Maryon T. Perspectives on patient and family engagement with reductions in harm. J Nurs Care Qual. 2019;34(1):73–79.
Ferlie EB, Shortell SM. Improving the quality of health care in the United Kingdom and the United States: a framework for change. Milbank Q. 2001;79(2):281–315.
Moore M, Robinson G, Mink R, et al. Developing a family-centered care model for critical care after pediatric traumatic brain injury. Pediatr Crit Care Med. 2015;16(8):758–765.
Office of Disease Prevention and Health Promotion. Older Adults: Objectives. Washington, DC: Office of Disease Prevention and Health Promotion: 2014. https://www.healthypeople.gov/2020/topics-objectives/topic/older-adults/objectives. Accessed December 13, 2018.
American Hospital Association. Connecting the dots along the care continuum. https://www.aha.org/system/files/2018-01/15carecontinuum.pdf. Published 2015. Accessed December 13, 2018.
Romano PS, Hussey P, Ritley D. Selecting Quality and Resource Use Measures: A Decision Guide for Community Quality Collaboratives. Rockville, MD: Agency for Health care Research and Quality; 2010.
Kennedy MS. Family caregivers need our help—and now it's the law [editorial]. Am J Nurs. 2017;118(5):7.
Benjamin R. Educating clients. In: Boyt Schell BA, Gillen G, Scaffa ME, Cohn ES, eds. Willard & Spackman's Occupational Therapy. Baltimore, MD: Wolters Kluwer: Lippincott Williams & Wilkins; 2014:353–362.