Palliative medicine · 2025
Addressing barriers to interprofessional working with homecare workers in community palliative care: Insights from a multi-site qualitative case study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Bayley Zana, Forward Cat, White Caroline, Elliott-Button Helene, Krygier Justine, Walker Liz, Pearson Mark, Hussain Jamilla, Taylor Paul, Wray Jane, Roberts Helen, Bravington Alison, Johnson Miriam J
Аннотация
BACKGROUND: Homecare workers (paid workers without professional qualifications who provide care for people within their own homes) are crucial providers of end-of-life care (the last 6 months of life) but are not part of the healthcare multidisciplinary team. Little is known about the homecare worker role within interprofessional working practices.
AIM: To explore the experiences of end-of-life homecare provision, from multiple perspectives.
DESIGN: A qualitative multiple case study using semi-structured interviews, and the option to create a Pictor chart - a visual diagram of relationships between those involved in care provision. Data were analysed using a reflexive thematic analysis. An adaptation of Bronfenbrenner's ecological systems theory was used to inform the analysis.
SETTING/PARTICIPANTS: Homecare workers and managers, people receiving care, carers, social, and healthcare practitioners from three economically and culturally diverse geographical regions within England.
RESULTS: 133 participants were recruited (case 1 = 49, case 2 = 34, case 3 = 49). Although examples of good practice were seen, common barriers to collaboration between health and social care practitioners and homecare workers were identified: lack of healthcare practitioner knowledge/training on homecare workers' role and its value, and poor communication (gatekeeping by managers, asynchronous working practices, restricted access to documentation and systems).
CONCLUSION: The homecare worker role was poorly understood and undervalued with inadequate communication and interaction between practitioners, potentially impacting on quality of care. Collaborative practice is necessary for provision of high-quality care, but we found this was often absent due to knowledge, professional, and organisational barriers. Further research should explore suggested strategies to address the barriers identified.
AIM: To explore the experiences of end-of-life homecare provision, from multiple perspectives.
DESIGN: A qualitative multiple case study using semi-structured interviews, and the option to create a Pictor chart - a visual diagram of relationships between those involved in care provision. Data were analysed using a reflexive thematic analysis. An adaptation of Bronfenbrenner's ecological systems theory was used to inform the analysis.
SETTING/PARTICIPANTS: Homecare workers and managers, people receiving care, carers, social, and healthcare practitioners from three economically and culturally diverse geographical regions within England.
RESULTS: 133 participants were recruited (case 1 = 49, case 2 = 34, case 3 = 49). Although examples of good practice were seen, common barriers to collaboration between health and social care practitioners and homecare workers were identified: lack of healthcare practitioner knowledge/training on homecare workers' role and its value, and poor communication (gatekeeping by managers, asynchronous working practices, restricted access to documentation and systems).
CONCLUSION: The homecare worker role was poorly understood and undervalued with inadequate communication and interaction between practitioners, potentially impacting on quality of care. Collaborative practice is necessary for provision of high-quality care, but we found this was often absent due to knowledge, professional, and organisational barriers. Further research should explore suggested strategies to address the barriers identified.