Slaugytojų patirtys vertinant artimųjų/globėjų įtraukimą į namų slaugos procesą ; Nurses' experience in assessing the involvement of informal caregivers in the home care process

Aušra Kunčienė. Nurses' experience in assessing the involvement of informal caregivers in the home care process. Master‘s thesis. Supervisor – Prof. Ph. Aurelija Blaževičienė. Lithuanian University of Health Sciences, Academy of Medicine, Faculty of Nursing. Kaunas, 2019; p. 92. The aim: to assess the experience of nurses in the process of involving informal caregivers in home care. Tasks: 1) What are the attitudes of nurses to the roles of relatives/caregivers in providing permanent nursing care services to patients with special needs? 2) What are the possibilities of relatives/caregivers to take care of patients with special needs at home from the point of view of nurses? 3) What is the point of view of nurses about the barriers relatives/caregivers face when caring of patients with special needs permanently at home? Methodology: During April – July, 2017 a qualitative study of three focus groups was conducted. The study included 31 nurses providing outpatient nursing services at home. The content of the informants' responses was analyzed by the method of qualitative content analysis, distinguishing categories and subcategories. Conclusions: The research has shown that the development of home care services in the concept of primary health care is based only on the possibility for nurses to live at home in the context of chronic illnesses, but it does not provide access to the right amount of health care. The relatives/caregivers largely dominate and fill the need for qualified care in home care by taking on the role of a nurse, becoming themselves informal caregivers, nurses, nursing needs‘ assessors, self-help teachers, managers, nurse representatives and lawyers. It turns out that relatives/caregivers are not prepared to deal with all the problems of providing nursing at home. They have sufficient competence to assess the needs of nurses, but not the changes in health status and the nursing procedures required. Research has shown that some relatives/caregivers have low health literacy, while others are self-reliant, interested in nursing issues, looking for information on the internet, in the press, and on television. It turned out that the greatest obstacles to home care are the unequal involvement of all family members, irresponsible attitudes of drinkers, unsuitable household conditions, the lack of compensated nursing care and the lack of state compensation for nursing costs. That largely goes to relatives/caregivers as a reward for nursing, but not for purchasing of the necessary services or nursing facilities. Residents/carers in home care have been identified as people facing social, psychological, physical, spiritual and ethical difficulties, which lead to greater need for informal and formal (inpatient and institutional ) care. Informants mentioned the necessity of the preparation and training of the relatives/caregivers, the implementation of the need for respite services and the possibilities of their rehabilitation.