Analysis of promotion and obstacles in long-term care grading services for home-based older adults with disabilities in China

Abstract

Long-term care (LTC) grading services refers to professional assessors using specific tools to systematically evaluate people with long-term care needs,develop and implement graded service standards that align with the care needs of individuals based on their varying levels of disability.It has been nearly a decade since China initiated home-based long-term care for the disabled elderly; however, challenges remain, such as the lack of detailed graded service standards and inadequate allocation of medical and nursing resources. This study aimed to gain insights into factors about influencing the current system by understanding the perspectives of those directly involved in providing care and to promote LTC services for older adults with disabilities in China.Using purposive sampling, nurses and certified nursing assistants were selected as participants for this qualitative study. Data were analysed using deductive method, guided by the Association Standard for Long-Term Care Grading Services for the Elderly, the Consolidated Framework for Implementation Research, and the Capability, Opportunity, and Motivation-Behavior (COM-B) model.This study identifies five themes—innovation, external and internal environmental factors, personal characteristics, and implementation process—along with five promoting and six obstacle factors. It explores nurses and certified nursing assistants perspectives on home-based long-term care grading for individuals with disabilities, offering a theoretical basis for a Chinese-specific long-term care model.