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Krieger T, Specht R, Errens B, Hagen U, Dorant E. Caring for Family Caregivers of Geriatric Patients: Results of a Participatory Health Research Project on Actual State and Needs of Hospital-Based Care Professionals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5901. [PMID: 32823889 PMCID: PMC7460178 DOI: 10.3390/ijerph17165901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/03/2020] [Accepted: 08/03/2020] [Indexed: 02/06/2023]
Abstract
Because of societal changes, family caregivers are becoming vital in long-term care provision for geriatric patients after discharge from hospital. Hospital-based geriatric care teams need tools to prepare and support family caregivers for their future caregiving role in the home environment. To explore the actual state and needs for implementing a suitable family caregiver support concept in a large geriatric hospital in Germany, a Participatory Health Research methodology was chosen. An academic investigator, assisted by a critical friend, facilitated all research steps. Geriatric care professionals joined as co-researchers and performed qualitative data collection using semi-structured interviews and focus group discussions. The entire co-research team took part in the thematic analyses. The existing family caregiver support was perceived as uncoordinated and incomplete, and a lack of knowledge about support programmes in the community was apparent. The needs regarding a comprehensive family caregiver support concept that acts on both individual caregiver as well as on system level, but also connects the two levels, were formulated. High grades of participation of hospital-based co-researchers could be achieved. A critical reflection on the research strategy revealed that the participatory methodology, although time-consuming, was perceived as a useful strategy within the hierarchically organized hospital.
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Affiliation(s)
- Theresia Krieger
- Department of Social Medicine, Faculty of Health Medicine and Life Sciences, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands;
| | - Regina Specht
- Helios Klinikum, An der Gontardslust 7, 57319 Bad Berleburg, Germany;
| | - Babette Errens
- Rhein-Maas Klinikum, Mauerfeldchen 25, 52146 Würselen, Germany; (B.E.); (U.H.)
| | - Ulrike Hagen
- Rhein-Maas Klinikum, Mauerfeldchen 25, 52146 Würselen, Germany; (B.E.); (U.H.)
| | - Elisabeth Dorant
- Department of Social Medicine, Faculty of Health Medicine and Life Sciences, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands;
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Aebischer Perone S, Nikolic R, Lazic R, Dropic E, Vogel T, Lab B, Lachat S, Hudelson P, Matis C, Pautex S, Chappuis F. Addressing the needs of terminally-ill patients in Bosnia-Herzegovina: patients' perceptions and expectations. BMC Palliat Care 2018; 17:123. [PMID: 30454032 PMCID: PMC6245800 DOI: 10.1186/s12904-018-0377-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 11/05/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many terminally ill patients in Bosnia-Herzegovina (BiH) fail to receive needed medical attention and social support. In 2016 a primary healthcare centreer (PHCC) in Doboj (BiH) requested the methodological and technical support of a local partner (Fondacija fami) and the Geneva University Hospitals to address the needs of terminally ill patients living at home. In order to design acceptable, affordable and sustainable solutions, we involved patients and their families in exploring needs, barriers and available resources. METHODS We conducted interviews with 62 purposely selected patients using a semi-structured interview guide designed to elicit patients' experiences, needs and expectations. Both qualitative and quantitative analyses were conducted, using an inductive thematic approach. RESULTS While patients were aware that their illnesses were incurable, they were poorly informed about medical and social support resources available to them. Family members appeared to be patients' main source of support, and often suffered from exhaustion and financial strain. Patients expressed feelings of helplessness and lack of control over their health. They wanted more support from health professionals for pain and other symptom management, as well as for anxiety and depression. Patients who were bedridden or with reduced mobility expressed strong feelings of loneliness, social exclusion, and stigma from community members and - occasionally - from health workers. CONCLUSIONS Our findings suggest a wide gap between patients' end-of-life care needs and existing services. In order to address the medical, psychological and social needs of terminally ill patients, a multi-pronged approach is called for, including not only better symptom management through training of health professionals and improved access to medication and equipment, but also a coordinated inter-professional, inter-institutional and multi-stakeholder effort aimed at offering comprehensive medical, psycho-social, educational and spiritual support.
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Affiliation(s)
- S Aebischer Perone
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 6, 1205, Geneva, Switzerland.
| | - R Nikolic
- Primary Health Care Center, Dom zdravja Doboj, Nemanjina 18, 74000, Doboj, Bosnia and Herzegovina
| | - R Lazic
- Primary Health Care Center, Dom zdravja Doboj, Nemanjina 18, 74000, Doboj, Bosnia and Herzegovina
| | - E Dropic
- Fondacija fami, Kralja Aleksandra 52, 74000, Doboj, Bosnia and Herzegovina
| | - T Vogel
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Avenue de Beau-Séjour 22, Geneva, Switzerland
| | - B Lab
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Avenue de Beau-Séjour 22, Geneva, Switzerland
| | - S Lachat
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Avenue de Beau-Séjour 22, Geneva, Switzerland
| | - P Hudelson
- Transcultural consultation and interpretation, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland
| | - C Matis
- Geriatrics and community palliative care unit, Geneva University Hospitals, Avenue Cardinal-Mermillod 36, 1227, Carouge, Switzerland
| | - S Pautex
- Geriatrics and community palliative care unit, Geneva University Hospitals, Avenue Cardinal-Mermillod 36, 1227, Carouge, Switzerland
| | - F Chappuis
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 6, 1205, Geneva, Switzerland
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Abstract
Informal caregiving is the most common form of long-term care provided in the United States, and with the projected rapid growth of older adults, informal caregiving will be even more critical in the foreseeable future. In the United States, slightly more than 20% of informal caregivers provide care for more than one care recipient, and 10% provide care for three or more care recipients. Caring for a dependent, older adult patient may have negative effects on physical, psychological, psychosocial, social and financial health of caregivers. Careful assessment of the impact of informal caregiving on the caregiver's functioning is imperative, and will enable a practitioner to not only find ways to help caregivers shoulder the effects of caregiving, but also to measure the effectiveness of interventions that seek to mitigate the effects of caregiving.
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Affiliation(s)
- Dorothea Frederick
- Jefferson College of Nursing (JCN), Thomas Jefferson University, Philadelphia, PA, USA
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