Strategies Used by Home Health Care Professionals Working With Older Adults to Navigate the Institutional Context: An Integrative Review

IF 0.8 Q4 NURSING

Home Health Care Management and Practice Pub Date : 2023-06-21 DOI:10.1177/10848223231183016

Alexandra Ethier, A. Carrier, M. Dubois

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引用次数: 0

Abstract

To respond to the needs of home healthcare (HHC) patients, HHC professionals must use strategies to navigate the influence of the institutional context, that is, laws and regulations, the administration, and the organization of HHC services. However, no synthesis of those strategies exists. This review aimed to synthesize the strategies used by HHC professionals working with older adults to navigate the institutional context. An integrative review was undertaken in 5 databases, from 2011 to January 2023. The quality of documents was assessed based on an adapted version of the Critical Review Form—Qualitative Studies (Version 2.0) in which a score was calculated out of 25, and data was analyzed through coding, data display and comparison. Thirteen documents were included. The quality of studies ranged from 13 to 21.75. Strategies are often used to overcome limited resources (e.g., time, funding). Six types of strategies were identified: Deviating (bypassing rules or processes), taking on more and more (taking additional work), offering one’s personal time (working without remuneration), reallocating resources (splitting HHC services between patients), limiting HHC visits (restricting interventions or actions) and relying on others (transferring responsibilities). The use of strategies could alleviate the discomfort felt by HHC professionals due to limited resources. However, as some strategies lead to a reduced scope of practice and to a loss of expertise, this could impede the quality of the care, resulting in non-responded needs for HHC patients.

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与老年人一起工作的家庭卫生保健专业人员在机构环境中使用的策略:一项综合回顾

为了响应家庭医疗保健(HHC)患者的需求，HHC专业人员必须使用策略来导航机构环境的影响，即法律法规、管理和HHC服务的组织。然而，这些策略的综合并不存在。本综述旨在综合HHC专业人员与老年人一起工作时使用的策略，以适应机构环境。从2011年到2023年1月，对5个数据库进行了综合评价。文献质量评估依据改编版的《批判性评价表-定性研究》(2.0版)，满分为25分，并通过编码、数据显示和比较等方式对数据进行分析。包括13份文件。研究质量从13到21.75不等。策略通常用于克服有限的资源(如时间、资金)。确定了六种策略:偏离(绕过规则或流程)、承担越来越多的工作(承担额外的工作)、提供个人时间(无报酬工作)、重新分配资源(在患者之间分配HHC服务)、限制HHC就诊(限制干预或行动)和依赖他人(转移责任)。策略的使用可以减轻HHC专业人员由于资源有限而感到的不适。然而，由于一些策略导致实践范围的缩小和专业知识的丧失，这可能会影响护理的质量，导致HHC患者的需求得不到回应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Home Health Care Management and Practice NURSING-

CiteScore

2.30

自引率

18.20%

发文量

期刊介绍： Home Health Care Management & Practice is a comprehensive resource for clinicians, case managers, and administrators providing home and community based health care. Articles address diverse issues, ranging from individual patient care and case management to the human resource management and organizational operations management and administration of organizations and agencies. Regular columns focus on research, legal issues, psychosocial perspectives, accreditation and licensing, compliance, management, and cultural diversity. Specific topics include treatment, care and therapeutic techniques, cultural competence, family caregivers, equipment management, human resources, home health center.