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From risky to safer home care: health care assistants striving to overcome a lack of training, supervision, and support.

Abstract：

:Patients receiving home care are becoming increasingly dependent upon competent caregivers' 24-h availability due to their substantial care needs, often with advanced care and home care technology included. In Sweden, care is often carried out by municipality-employed paraprofessionals such as health care assistants (HC assistants) with limited or no health care training, performing advanced care without formal training or support. The aim of this study was to investigate the work experience of the HC assistants and to explore how they manage when delivering 24-h home care to patients with substantial care needs. Grounded theory methodology involving multiple data sources comprising interviews with HC assistants (n=19) and field observations in patients' homes was used to collect data and constant comparative analysis was used for analysis. The initial analysis revealed a number of barriers, competence gap; trapped in the home setting; poor supervision and unconnected to the patient care system, describing the risks associated with the situations of HC assistants working in home care, thus affecting their working conditions as well as the patient care. The core process identified was the HC assistants' strivings to combine safe home care with good working conditions by using compensatory processes. The four identified compensatory processes were: day-by-day learning; balancing relations with the patient; self-managing; and navigating the patient care system. By actively employing the compensatory processes, the HC assistants could be said to adopt an inclusive approach, by compensating for their own barriers as well as those of their colleagues' and taking overall responsibility for their workplace. In conclusion, the importance of supporting HC assistants in relation to their needs for training, supervision,and support from health care professionals must be addressed when organising 24-h home care to patients with substantial care needs in the future.

journal_name

Int J Qual Stud Health Well-being

journal_title

International journal of qualitative studies on health and well-being

authors

Swedberg L,Chiriac EH,Törnkvist L,Hylander I

doi

10.3402/qhw.v8i0.20758

subject

Has Abstract

pub_date

2013-05-23 00:00:00

pages

20758

eissn

1748-2623

issn

1748-2631

pii

20758

journal_volume

pub_type

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From risky to safer home care: health care assistants striving to overcome a lack of training, supervision, and support.