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1.
BMC Prim Care ; 23(1): 325, 2022 12 14.
Artigo em Inglês | MEDLINE | ID: mdl-36517792

RESUMO

BACKGROUND: Since COVID-19 emerged, over 514 million COVID-19 cases and 6 million COVID-19-related deaths have been reported worldwide. Older persons receiving home health care often have co-morbidities that require advanced medical care, and are at risk of becoming severely ill or dying from COVID-19. In Sweden, over 10,000 COVID-19-related deaths have been reported among persons receiving municipal home health and social care. Home health care professionals have been working with the patients most at risk if infected. Most research has focused on the experiences of professionals in hospitals and assistant nurses in a home care setting. It is therefore valuable to study the experiences of the registered nurses and physicians working in home health care during the COVID-19 pandemic to learn lessons to inform future work. METHOD: A thematic qualitative study design using a semi-structured interview guide. RESULTS: The health care professionals experienced being forced into changed ways of working, which disrupted building and maintaining relationships with other health care professionals, and interrupted home health care. The health care professionals described being forced into digital and phone communication instead of in-person meetings, which negatively influenced the quality of care. The COVID-19 pandemic brought worry about illness for the health care professionals, including worrying about infecting patients, co-workers, and themselves, as well as worry about upholding the provision of health care because of increasing sick leave. The health care professionals felt powerless in the face of their patients' declining health. They also faced worry and guilt from the patients' next of kin. CONCLUSION: Home health care professionals have faced the COVID-19 pandemic while working across organizational borders, caring for older patients who have been isolated during the pandemic and trying to prevent declining health and feelings of isolation. Due to the forced use of digital and phone communication instead of in-person visits, the home health care professionals experienced a reduction in the patients' quality of care and difficulty maintaining good communication between the professions.


Assuntos
COVID-19 , Visitadores Domiciliares , Humanos , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , Pandemias , Pesquisa Qualitativa , Pessoal de Saúde
2.
Healthc Policy ; 18(2): 61-75, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36495535

RESUMO

Background: Governments introduced emergency measures to address the shortage of homecare workers and unmet care needs in Canada during the COVID-19 pandemic. Objective: This article aims to describe how policies impacted home care and identifies the potential risks for clientele and staff. Method: Experts in home care (n = 15) were interviewed about policies that affect health and safety for homecare recipients. Results: New recruitment strategies, condensed education and rapid hiring during the pandemic did not lead to the recruitment of sufficient workers, but increased the potential for recruitment of unsuitable workers or workers with little training. Conclusion: It is important to consider the unintended effects of emergency policy measures and to manage the effects of such policies on homecare clients.


Assuntos
COVID-19 , Serviços de Assistência Domiciliar , Visitadores Domiciliares , Humanos , Pandemias , COVID-19/epidemiologia , Ontário/epidemiologia
3.
BMC Health Serv Res ; 22(1): 1159, 2022 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-36104816

RESUMO

BACKGROUND: Participatory research is particularly suitable in adressing know-do gaps in health systems. There is a disparity between what is known about the benefits of social participation and home care's responsibility to provide conditions amenable to older adults' social participation, and what is accomplished in home care practice. Home care workers are a large, low-power group, whose competences should be better harnessed. We carried out a participatory action research (PAR) project with the goal of generating an improved structure for identifying and alleviating loneliness. This article aims to explore the co-creative process of designing a work model that guides home care workers in supporting social participation among older care recipients. METHODS: Multimodal data from 16 PAR workshops with 14 home care workers were described and explored through the 'recursive PAR process' and the 'framework for occupational enablement for change in community practice". RESULTS: The PAR process is outlined through the objectives, activities, and work model, as well as enablement strategies employed throughout the PAR process; as are its opportunities, challenges and implications. The work model describes how care workers can act as discoverers of care recipients' unmet social needs, employ intentional communication, and link to relevant professions or community services to alleviate loneliness among older home care recipients. CONCLUSIONS: This research process included opportunities of collaborating with enthusiastic and competent home care workers, but also challenges of moving between theory and practice and maintaining active participation between workshops. The resulting work model is in step with the requirements of elderly care, is unique in its field and could comprise a first step toward a more systematic approach of assessing and addressing loneliness. The vivid delineation of the PAR process provided in this paper can aid other researchers in navigating participatory research in home care contexts.


Assuntos
Serviços de Assistência Domiciliar , Visitadores Domiciliares , Idoso , Serviços de Saúde Comunitária , Humanos , Solidão , Participação Social
4.
J Med Internet Res ; 24(11): e39997, 2022 11 11.
Artigo em Inglês | MEDLINE | ID: mdl-36176033

RESUMO

BACKGROUND: Home health aides (HHAs) provide necessary hands-on care to older adults and those with chronic conditions in their homes. Despite their integral role, HHAs experience numerous challenges in their work, including their ability to communicate with other health care professionals about patient care while caring for patients and access to educational resources. Although technological interventions have the potential to address these challenges, little is known about the technological landscape and existing technology-based interventions designed for and used by this workforce. OBJECTIVE: We conducted a scoping review of the scientific literature to identify existing studies that have described, designed, deployed, or tested technology-based tools and apps intended for use by HHAs to care for patients at home. To complement our literature review, we conducted a landscape analysis of existing mobile apps intended for HHAs providing in-home care. METHODS: We searched the following databases from their inception to October 2020: Ovid MEDLINE, Ovid Embase, Cochrane Library, and CINAHL (EBSCO). A total of 3 researchers screened the yield using prespecified inclusion and exclusion criteria. In addition, 4 researchers independently reviewed these articles, and a fifth researcher arbitrated when needed. Among studies that met the inclusion criteria, data were extracted and summarized narratively. An analysis of mobile health apps designed for HHAs was performed using a predefined set of terms to search Google Play and Apple App stores. Overall, 2 researchers independently screened the resulting apps, and those that met the inclusion criteria were categorized according to their intended purpose and functionality. RESULTS: Of the 8643 studies retrieved, 182 (2.11%) underwent full-text review, and 4.9% (9/182) met our inclusion criteria. Approximately half (4/9, 44%) of the studies were descriptive in nature, proposing technology-based systems (eg, web portals and dashboards) or prototypes without a technical or user-based evaluation of the technology. In most (7/9, 78%) papers, HHAs were just one of several users and not the sole or primary intended users of the technology. Our review of mobile apps yielded 166 Android and iOS apps, of which 48 (29%) met the inclusion criteria. These apps provided HHAs with one or more of the following functions: electronic visit verification (29/48, 60%), clocking in and out (23/48, 48%), documentation (22/48, 46%), task checklist (19/48, 40%), communication between HHA and agency (14/48, 29%), patient information (6/48, 13%), resources (5/48, 10%), and communication between HHA and patients (4/48, 8%). Of the 48 apps, 25 (52%) performed monitoring functions, 4 (8%) performed supporting functions, and 19 (40%) performed both. CONCLUSIONS: A limited number of studies and mobile apps have been designed to support HHAs in their work. Further research and rigorous evaluation of technology-based tools are needed to assess their impact on the work HHAs provide in patient's homes.


Assuntos
Visitadores Domiciliares , Aplicativos Móveis , Telemedicina , Envio de Mensagens de Texto , Humanos , Idoso , Telemedicina/métodos , Tecnologia
5.
AMA J Ethics ; 24(9): E822-829, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-36170413

RESUMO

This commentary on a case offers a historical perspective on how home health work became separate from other sites and means of professional caregiving, exacerbating poor continuity of care in the US health care system. Categorizing home health work as domestic work continues to racialize and marginalize workers. Poor public policy responding to market pressures to keep home health work cheap also perpetuates home health workers' classification as independent contractors, their lack of training, and low wages. This commentary suggests an alternative model for the future of home health work in the United States.


Assuntos
Serviços de Assistência Domiciliar , Visitadores Domiciliares , Atenção à Saúde , Pessoal de Saúde , Mão de Obra em Saúde , Humanos , Organizações , Estados Unidos
6.
AMA J Ethics ; 24(9): E860-866, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-36170418

RESUMO

The National Domestic Worker's Bill of Rights Act aimed to remedy nearly a century of labor and health inequities facing a majority of the home health workforce-including home health workers, personal care aides, and professional caregivers-who are women of color and immigrants. Although the bill did not pass, the National Domestic Workers Alliance and its affiliates continue to organize a new labor movement inclusive of home care workers that supports federal legislation and adequate labor protections for their members, particularly in right-to-work states like Texas and in municipalities where hazardous working conditions and low wages contribute to the perceived disposability and devaluation of care labor. Home care workers require federal labor protections that will hold states accountable for the health and well-being of this essential workforce.


Assuntos
Serviços de Assistência Domiciliar , Visitadores Domiciliares , Feminino , Pessoal de Saúde , Mão de Obra em Saúde , Humanos , Masculino , Recursos Humanos
7.
Workplace Health Saf ; 70(11): 493-499, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35975760

RESUMO

BACKGROUND: Workplace violence incidents remain pervasive in health care. Home care workers like personal support workers (PSWs) provide services for clients with dementia, which has been identified as a risk factor for workplace violence. The objective of this study was to evaluate whether the implementation of a rapid response algorithm resolved unsafe working conditions associated with responsive behaviors and decreased perception of risk. METHODS: A nonexperimental pre- and post-evaluation design was utilized to collect data from PSWs and supervisors. PSWs completed an online survey about their experience with workplace violence and perception of risk. Bi-weekly check-ins were conducted with supervisors to track incidents and their level of resolution in the algorithm. Semi-structured interviews were also conducted to gather in-depth feedback about the algorithm in practice. FINDINGS: We found no difference in risk perception among PSWs pre- and post-implementation. However, PSWs who had been employed for less than 1 year had a significantly higher risk perception. Overall, the algorithm was found to be helpful in resolving workplace violence incidents. CONCLUSION AND APPLICATION TO PRACTICE: Opportunity exists to further refine the algorithm and ongoing dissemination, and implementation of the algorithm is recommended to continually address incidents of workplace violence. Newly hired PSWs may require additional supports. Ongoing education and training were identified as key mitigation strategies.


Assuntos
Serviços de Assistência Domiciliar , Visitadores Domiciliares , Violência no Trabalho , Humanos , Inquéritos e Questionários , Algoritmos , Local de Trabalho
8.
BMC Health Serv Res ; 22(1): 956, 2022 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-35897061

RESUMO

BACKGROUND: Being physically active is important for maintaining function and independence in older age. However, there is insufficient knowledge about how to successfully promote physical activity (PA) among home-dwelling older adults with functional challenges in real-life healthcare settings. Reablement is an interdisciplinary, person-centered approach to restoring function and independence among older adults receiving home care services; it also may be an opportunity to promote PA. However, reablement occurs in many different contexts that influence how PA can be integrated within reablement. This study aimed to identify facilitators and barriers experienced by healthcare professionals (HCPs) that influence the promotion of PA within the context of reablement. METHODS: This exploratory qualitative study is guided by a realist perspective and analyzed through inductive content analysis. Sixteen HCPs, including occupational therapists, physical therapists, registered nurses, and home care workers, participated in semi-structured interviews. The HCPs were recruited from four Norwegian municipalities with diverse sizes and different organizational models of reablement. RESULTS: The HCPs experienced several facilitators and barriers at the participant, professional, organizational, and system levels that influenced how they promoted PA through reablement. Factors related to the individual person and their goals were considered key to how the HCPs promoted PA. However, there were substantial differences among reablement settings regarding the degree to which facilitators and barriers at other levels influenced how HCPs targeted individual factors. These facilitators and barriers influenced how the HCPs reached out to people who could benefit from being more physically active; targeted individual needs, desires and progression; and promoted continued PA habits after reablement. CONCLUSIONS: These findings exemplify the complexity of facilitators and barriers that influence the promotion of PA within the reablement context. These factors are important to identify and consider to develop and organize healthcare services that facilitate older adults to be active. We recommend that future practice and research in reablement acknowledge the variations between settings and consider mechanisms on a participant and professional level and within an integrated care perspective.


Assuntos
Serviços de Assistência Domiciliar , Visitadores Domiciliares , Fisioterapeutas , Idoso , Atenção à Saúde , Exercício Físico , Humanos
9.
BMC Prim Care ; 23(1): 129, 2022 05 26.
Artigo em Inglês | MEDLINE | ID: mdl-35619098

RESUMO

BACKGROUND: The COVID-19 pandemic has caused home health care workers (home-HCWs) to experience anxiety. The mental health of home-HCWs and related factors during the COVID-19 pandemic have not been clarified; therefore, we aimed to investigate the status and associated factors of fear of COVID-19 infection, anxiety, and depression among home-HCWs in Japan. METHODS: We conducted a multicenter cross-sectional web-based anonymous survey of home-HCWs in August 2021, during the fifth wave of the pandemic in Japan. We surveyed members of facilities that provided home visit services during the COVID-19 pandemic. We measured the Japanese version of the Fear of COVID-19 scale (FCV-19S-J) and the Hospital Anxiety and Depression scale (HADS) as objective variables, and the Japanese version of the Assessment of Interprofessional Team Collaboration Scale-II (J-AITCS-II) as an explanatory variable. RESULTS: A total of 328 members of 37 facilities responded to the survey, and we ultimately analyzed 311 participants. The most frequent occupation was nurse (32.8%), followed by doctor (24.8%) and medical office staff (18.0%). The mean score of the FCV-19S-J was 16.5 ± 5.0 (7.0 - 31.0), and the prevalences of definitive anxiety and depression were 7.4% and 15.7%, respectively. Multivariate regression analysis revealed that the J-AITCS-II teamwork subscale was significantly negatively associated with FCV-19S-J, HADS-anxiety, and HADS-depression (ß = -0.171, p = 0.004; ß = -0.151, p = 0.012; ß = -0.225, p < 0.001, respectively). Medical office staff showed significant positive associations with FCV-19S-J and HADS-depression (ß = 0.219, p = 0.005; ß = 0.201, p = 0.009, respectively), and medical social workers with HADS-anxiety and HADS-depression (ß = -0.166, p = 0.011; ß = -0.214, p < 0.001, respectively) compared with doctors. The unmet support need for expert lectures on COVID-19 was significantly positively associated with FCV-19S-J (ß = 0.131, p = 0.048), and the unmet support need for support systems for psychological stress and emotional exhaustion was significantly positively associated with HADS-anxiety (ß = 0.141, p = 0.022). CONCLUSIONS: Fear of COVID-19 infection and depression of nurses, medical office staff, and other occupations was significantly higher than those of doctors. These findings suggest that non-physicians were more likely to be fearful and depressed during the COVID-19 pandemic; thus, it is necessary to tailor mental health support based on occupation in the home care setting.


Assuntos
COVID-19 , Visitadores Domiciliares , COVID-19/epidemiologia , Estudos Transversais , Humanos , Internet , Japão/epidemiologia , Saúde Mental , Pandemias
11.
Workplace Health Saf ; 70(7): 325-331, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35466840

RESUMO

BACKGROUND: The threat of workplace violence (WPV) is a primary safety concern for home health care workers (HHCWs). WPV prevention training is a critical tool for HHCWs' safety. Yet, most existing WPV prevention training is limited or not specific to HHCWs' environment, the patient's home, and neighborhood. The purpose of this study was to describe WPV prevention training, resources used, and commitment to HHCWs' safety. METHODS: Using a cross-sectional design, HHCWs from two sites located in Southwestern Ohio completed the Violence Against Home Healthcare and Hospice Workers survey, a 37-item survey used to describe frequency and characteristics of WPV prevention training and resources. Descriptive statistics were used to analyze the data. FINDINGS: Half (n = 25) of the HHCWs received WPV prevention training. Training content focused on characteristics of aggressive/violent patients and family members (n = 19, 82.6%), but limited content about characteristics of hazardous neighborhoods (n = 15, 65.2%). Cellular phones (n = 43, 97.7%) were primarily used as a resource to promote safety, few cellular phones (n = 1, 2.3%) were provided by the agency. CONCLUSIONS/APPLICATION TO PRACTICE: HHCWs described WPV prevention training content and resources used to promote safety. WPV prevention training is deficient in procedures for seeking psychological care, screening patients for violent behavior, skills for self-protection, characteristics of hazardous neighborhoods, and physical maneuvers and verbal methods to diffuse or avoid aggressive behavior. Access to WPV prevention training and resources for HHCWs needs to be strengthened. Occupational Health Nurses can assist their employers with developing WPV prevention training for HHCWs.


Assuntos
Visitadores Domiciliares , Violência no Trabalho , Estudos Transversais , Humanos , Inquéritos e Questionários , Local de Trabalho/psicologia
12.
Artigo em Inglês | MEDLINE | ID: mdl-35409520

RESUMO

Nursing literature predominantly focuses on job demands but is scarce for resources related to nurses' work. In the face of the COVID-19 pandemic, resources that can buffer the health-impairing effects of increased demands gain importance. The aim of this study is to explore resilience, meaning of work and joyful moments in home health care workers in South Germany during the pandemic. Resilience and meaning of work were measured quantitatively; moments of joy were investigated qualitatively by audio diaries and analyzed with qualitative content analysis. In all, 115 home health care workers (mean age = 47.83 ± 11.72; 81.75% female) filled in the questionnaires and 237 diary entries were made by 23 persons (mean age = 46.70 ± 10.40; 91.30% female). The mean scores of resilience (5.52 ± 1.04; 1-7) and meaning of work (4.10 ± 0.92; 1-5) showed high levels, with significantly higher values in females. Home care workers experienced joyful moments 334 times in 60 different types in the categories of social relationships, work content, work organization, work environment and self-care. A deeper understanding of resilience, meaning of work and joyful moments provides a basis for the development of worksite health promotion programs that address both demands and resources in home health care workers.


Assuntos
COVID-19 , Visitadores Domiciliares , Adulto , COVID-19/epidemiologia , Feminino , Alemanha , Humanos , Satisfação no Emprego , Masculino , Pessoa de Meia-Idade , Pandemias
13.
J Appl Gerontol ; 41(7): 1710-1721, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35420904

RESUMO

As part of its Medicaid program restructuring, New York State funded 11 Workforce Investment Organizations (WIO) to support training initiatives for the long-term care workforce. Focusing on one WIO, this formative evaluation examined quality improvement training programs delivered to 11,163 Home Health Aides employed by home care agencies serving clients of Managed Long-Term Care plans. Results are presented from a thematic analysis of qualitative interviews with organizational and program stakeholders examining contextual factors influencing program objectives, implementation, barriers and facilitators, and perceived outcomes. Findings suggested that WIO training programs were implemented during a period of shifting organizational strategies alongside value-based payment reforms and challenges to aide recruitment and retention. Stakeholders appraised WIO training programs positively and valued program flexibility and facilitation of communication and collaboration between agencies and plans. However, delivery and implementation challenges existed, and industry-wide structural fragmentation led stakeholders to question the WIO's larger impact.


Assuntos
Serviços de Assistência Domiciliar , Visitadores Domiciliares , Humanos , Assistência de Longa Duração , Medicaid , New York , Estados Unidos , Recursos Humanos
14.
J Gen Intern Med ; 37(8): 1830-1837, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35319082

RESUMO

BACKGROUND: Home health aides are important but often overlooked members of care teams, providing functional and emotional support to patients. These services became increasingly important during the COVID-19 pandemic as older adults faced disruptions in in-person medical services and family caregiving. Understanding how aides supported healthcare teams is important for informing emergency planning and better integrating home health services with primary care. OBJECTIVE: To describe aides' roles in supporting veterans and working with primary care teams during COVID-19 and identify COVID-related changes in tasks. DESIGN: Semi-structured interviews. PARTICIPANTS: Eight home health aides, 6 home health agency administrators, and 9 primary care team members (3 RNs, 3 social workers, 3 MDs) serving veterans at a large, urban, Veterans Affairs medical center. APPROACH: Combined deductive and inductive analysis to identify a priori concepts (aide roles; changes in tasks and new tasks during COVID-19) and emergent ideas. Aide, administrator, and provider interviews were analyzed separately and compared and contrasted to highlight emergent themes and divergent perspectives. KEY RESULTS: Participants reported an increase in the volume and intensity of tasks that aides performed during the pandemic, as well as the shifting of some tasks from the medical care team and family caregivers to the aide. Four main themes emerged around aides' roles in the care team during COVID-19: (1) aides as physically present "boots on the ground" during medical and caregiving disruptions, (2) aides as care coordination support, (3) aides as mental health support, and (4) intensification of aides' work. CONCLUSIONS: Home health aides played a central role in coordinating care during the COVID-19 pandemic, providing hands-on functional, medical, and emotional support. Integrating aides more formally into healthcare teams and expanding their scope of practice in times of crisis and beyond may improve care coordination for older veterans.


Assuntos
COVID-19 , Visitadores Domiciliares , Veteranos , Idoso , COVID-19/epidemiologia , COVID-19/terapia , Visitadores Domiciliares/psicologia , Humanos , Pandemias , Equipe de Assistência ao Paciente , Atenção Primária à Saúde
15.
Am J Ind Med ; 65(6): 447-467, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35352369

RESUMO

BACKGROUND: Home care is a rapidly growing industry. Violence towards home care workers is common, while also likely underreported. This violence adversely affects the physical and mental health of both workers and care recipients. The current study aims to identify and appraise recent evidence on the determinants of violence towards care workers working in the home setting. METHODS: Six electronic databases: the Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Informit, Medline, PsycINFO, and Web of Science, were systematically searched. A systematic review was conducted in accordance with the Joanna Briggs Institute manual for evidence synthesis. RESULTS: A total of 18 papers met the inclusion criteria. All were cross-sectional surveys. The majority of studies were from the United States. The most commonly investigated associations were those between the medical history of clients, workers' apprehension of violence, worker-client relationship, or care plans, and any form of violence or verbal abuse. CONCLUSION: Violence was common in clients with cognitive disorders, substance abuse disorder, and limited mobility; toward workers who feared that violence might happen; toward those who had very close or very distant worker-client relationships; and when care plans were not inclusive of clients' needs. The current review highlights a gap in evidence on determinants of violence towards care workers working in the home setting, and suggests potential areas to be addressed to reduce such violence.


Assuntos
Serviços de Assistência Domiciliar , Visitadores Domiciliares , Pessoal de Saúde , Humanos , Saúde Mental , Violência
16.
Artigo em Inglês | MEDLINE | ID: mdl-35162335

RESUMO

As the locus of long-term care in the United States shifts from institutions to the community, paid caregivers (i.e., home health aides, personal care attendants) are providing more hands-on care to persons with dementia living at home. Yet, little is known about how family caregivers engage with paid caregivers. We conducted in-depth, semi-structured interviews (n = 15) with family caregivers, of persons living at home with severe dementia, and enriched our findings with data from a second cohort of family caregivers of persons with dementia (n = 9). Whether paid caregivers were hired privately or employed via a Medicaid-funded agency, family caregivers reported that they needed to manage paid caregivers in the home. Core management tasks were day-to-day monitoring and relationship building with family caregivers; training paid caregivers and coordinating care with homecare agencies was also described. In order to support family caregivers of individuals with dementia at home, it is important consider their preferences and skills in order to effectively manage paid caregivers. Support of efforts to build a high-quality paid caregiving workforce has the potential to improve not only care delivered to persons with dementia, but the experiences of their family caregivers.


Assuntos
Demência , Agências de Assistência Domiciliar , Serviços de Assistência Domiciliar , Visitadores Domiciliares , Cuidadores/educação , Demência/terapia , Humanos , Salários e Benefícios , Estados Unidos
17.
J Cross Cult Gerontol ; 37(1): 1-22, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35179682

RESUMO

Despite dramatic expansions in the Chinese nursing home sector in meeting the increasing care needs of a rapidly aging population, direct care work in China remains largely devalued and socially unrecognized. Consequently, scant attention has been given to the caregiving experiences of direct care workers (DCWs) in Chinese nursing homes. In particular, given the relational nature of care work, there is little knowledge as to how Chinese DCWs manage emotions and inner feelings through their emotional labor. This article examines the emotional labor of Chinese DCWs through ethnographic data collected with 20 DCWs in one nursing home located in an urban setting in central China. Data were analyzed using conventional content analysis and constant comparison. Participants' accounts of sustaining a caring self, preserving professional identity, and hoping for reciprocity revealed implicit meanings about the often-conflicting nature of emotional labor and the nonreciprocal elements of care work under constrained working conditions. Importantly, the moral-cultural notion of bao ( norm of reciprocity) was found to be central among DCWs in navigating strained resources and suggested their agency in meaning-construction. However, their constructed moral buffers may be insufficient if emotional labor continues to be made invisible by care organizations.


Assuntos
Visitadores Domiciliares , Idoso , China , Emoções , Pessoal de Saúde , Humanos , Casas de Saúde
18.
Health Soc Care Community ; 30(5): e2928-e2939, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35128740

RESUMO

Most people living with dementia want to continue living in their own home for as long as possible and many rely on support from homecare services to do so. There are concerns that homecare often fails to meet the needs of clients with dementia, but there is limited evidence regarding effective interventions to improve its delivery for this client group. We aimed to assess whether a co-designed, 6-session dementia training intervention for homecare workers (NIDUS-professional) was acceptable and feasible. Facilitated training sessions were delivered over 3 months, followed by 3, monthly implementation meetings to embed changes in practice. Two trained and supervised facilitators without clinical qualifications delivered the intervention via group video-calls during Oct 2020-March 2021 to a group of seven homecare workers from one agency in England. Participants provided qualitative feedback 3- and 6-months post intervention. Qualitative interview data and facilitator notes were integrated in a thematic analysis. Adherence to the intervention and fidelity of delivery were high, indicating that it was acceptable and feasible to deliver in practice. Thirty of a possible 42 (71.4%) group sessions were attended. In our thematic analysis we report one over-arching theme: 'Having time and space to reflect is a rare opportunity'. Within this we identified four subthemes (Having time to reflect is a rare opportunity; Reflecting with peers enhances learning; Reflection and perspective taking can improve care; Recognising skills and building confidence) through which we explored how participants valued the intervention to discuss their work and learn new skills. Attendance was lower for the implementation sessions, perhaps reflecting participants' lack of clarity about their purpose. We used our findings to consider how we can maintain positive impacts of the manualised sessions, so that these are translated into tangible, scalable benefits for people living with dementia and the homecare workforce. A randomised feasibility trial is underway.


Assuntos
COVID-19 , Demência , Serviços de Assistência Domiciliar , Visitadores Domiciliares , COVID-19/epidemiologia , Demência/terapia , Humanos , Pandemias
20.
Res Aging ; 44(7-8): 611-618, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35118921

RESUMO

Research on migrant home care workers has focused mainly on working conditions in the recipient countries and on the relationships between care recipients and their family members. However, because migrant care workers often are transnational, going back and forth between countries, some return to their home country, bringing with them newly acquired attitudes and practices. Based on a theoretical model of the transfer of innovation, this study aims to explore changes in attitudes toward aging and elder care among former migrant care workers. We conducted 13 in-depth interviews with migrant care workers who permanently returned to Lithuania. Data were analyzed thematically. Findings revealed changes in workers' perceptions of aging, including perceptions of their own old age, older people, and elder care. These changes were mainly attributed to their personal connections and encounters with different cultural attitudes and practices in the host country. Our findings indicate that returning migrant home care workers may act as potential innovators who bring back to their home country new ideas about aging and elder care.


Assuntos
Visitadores Domiciliares , Migrantes , Idoso , Envelhecimento , Atitude , Pessoal de Saúde , Humanos
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