Health & social care in the community
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Health Soc Care Community · Sep 2016
ReviewApproaches to capturing the financial cost of family care-giving within a palliative care context: a systematic review.
The economic burden faced by family caregivers of people at the end of life is well recognised. Financial burden has a significant impact on the provision of family care-giving in the community setting, but has seen limited research attention. A systematic review with realist review synthesis and thematic analysis was undertaken to identify literature relating to the financial costs and impact of family care-giving at the end of life. ⋯ Calculation of costs was most often based on recall by patients and family caregivers, in some studies combined with objective measures of resource use. While the studies in this review provide useful data on approaches to capturing costs of care-giving, more work is needed to develop methods which accurately and sensitively capture the financial costs of caring at the end of life. Methodological considerations include study design and method of administration, contextual and cultural relevance, and accuracy of cost estimates.
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Health Soc Care Community · Sep 2016
ReviewA scoping study: children, policy and cultural shifts in homelessness services in South Australia: are children still falling through the gaps?
Homeless families are the fastest growing segment of the homelessness population. Homelessness services are often the first to know when children are at risk of disengagement with health, welfare and education services. Changes to Australian policy to explicitly attend to the needs of children are attempts to address the complexity of, and provide better outcomes for, homeless children. ⋯ Therefore, the objectives of this scoping study were to: (i) identify the specific needs of children in homelessness; (ii) describe recent changes in policy relating to care for children in homelessness services; (iii) explore the evidence on how service providers can enact care for children in homelessness services; (iv) identify the types of practice changes that are needed to optimise outcomes for children; and (v) identify the gaps in service delivery. This article describes the Australian policy changes and explores the potential impact of subsequent sector reforms on the internal practices in front-line homelessness services, in order to overcome structural and systemic barriers, and promote opportunities for children in homeless families. This scoping study literature review contributes to the understanding of the impact of policy change on front-line staff and suggests possible practice changes and future research options.
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Health Soc Care Community · Sep 2016
Interpreters' subjective experiences of interpreting for refugees in person and via telephone in health and behavioural health settings in the United States.
Interpreters, whether in person or via telephonic means, are used in healthcare settings to aid communication between clinicians and clients when the same language is not shared. Refugees seeking health and behavioural healthcare often have multiple needs and experiences of trauma that can complicate the provision of services. Little is known about the interpreters' experiences in providing in-person and telephonic interpreting for refugees. ⋯ Two themes were identified: (i) the importance for the interpreter to develop trust with the client; and (ii) working with refugees requires more attention from the interpreter. The interpreters of this study describe experiencing additional challenges in working with refugees versus other clients. Recommendations based on the findings are made.
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Health Soc Care Community · Jul 2016
Predictors of caregiver burden across the home-based palliative care trajectory in Ontario, Canada.
Family caregivers of patients enrolled in home-based palliative care programmes provide unpaid care and assistance with daily activities to terminally ill family members. Caregivers often experience caregiver burden, which is an important predictor of anxiety and depression that can extend into bereavement. We conducted a longitudinal, prospective cohort study to comprehensively assess modifiable and non-modifiable patient and caregiver factors that account for caregiver burden over the palliative care trajectory. ⋯ Low patient functional status was the strongest predictor of burden. Understanding the influence of modifiable and non-modifiable factors on the experience of burden over the palliative trajectory is essential for the development and targeting of programmes and policies to support family caregivers and reduce burden. Supporting caregivers can have benefits such as improved caregiver health outcomes, and enhancing their ability to meet care-giving demands, thereby potentially allowing for longer patient care in the home setting.
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Health Soc Care Community · May 2016
ReviewPatient-professional partnerships and chronic back pain self-management: a qualitative systematic review and synthesis.
Chronic back pain is common, and its self-management may be a lifelong task for many patients. While health professionals can provide a service or support for pain, only patients can actually experience it. It is likely that optimum self-management of chronic back pain may only be achieved when patients and professionals develop effective partnerships which integrate their complementary knowledge and skills. ⋯ These themes were developed into a model suggesting how factors within patient-professional partnerships influence self-management. Review findings suggest that a partnership between patients and professionals supports patients' self-management ability, and effective communication is a fundamental factor underpinning their partnerships in care. It also calls for the development of individualised healthcare services offering self-referral or telephone consultation to patients with chronic conditions.