Actions to influence the care network of home‐dwelling elderly people: A qualitative study

Kemper-Koebrugge, Wendy; ­Adriaansen, Marian; Laurant, Miranda; Wensing, Michel

doi:10.1111/hsc.12714

Cited by 9 publications

(12 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We are uncertain to what extent healthcare professionals and patients recognize and report network-related processes. Previous studies suggested that the range of factors, mechanisms and processes is substantially broader than perceived and reported by patients or providers in interviews [28].…”

Section: Discussionmentioning

confidence: 95%

Cooperation networks of ambulatory health care providers: exploration of mechanisms that influence coordination and uptake of recommended cardiovascular care (ExKoCare): a mixed-methods study protocol

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background: As the number of elderly and multimorbid patients increases, healthcare has become more complex. This requires good coordination of treatment and care given the various health care professionals involved (e.g. general practitioners, medical specialists, physicians' assistants). Lack of coordination jeopardizes seamless, evidence-based treatment and care, and eventually reduces clinical effectiveness. The aim of the study is a) to describe and explore information transfer and interprofessional collaboration in ambulatory cardiac care, b) to describe and explore the role of provider networks from the perspective of patients and providers, focusing on healthcare coordination and the uptake of recommended practices. Methods: Two related studies are planned: a) an observational study of healthcare provider networks, involving 600 patients with chronic (atherosclerosis-related) cardiovascular disease from 40 general practices and up to 320 healthcare providers (general practitioners, medical specialist, physicians' assistants), and b) a qualitative interview study with up to 80 healthcare professionals and patients. Furthermore, we will analyse claims data of a large German health insurer to explore provider networks in ambulatory cardiac care. Discussion: The project aims to provide insight into factors, processes and mechanisms of information transfer and interprofessional collaboration, which affect seamless, evidence-based healthcare practice. This will contribute to the design of strategies for improving health care practice and to the development of measures of coordination for future research. Trial registration: We registered the study prospectively on 7 November 2019 at the German Clinical Trials Register (DRKS, www.drks.de) under ID no. DRKS00019219.

show abstract

Section: Discussionmentioning

confidence: 95%

Cooperation networks of ambulatory health care providers: exploration of mechanisms that influence coordination and uptake of recommended cardiovascular care (ExKoCare): a mixed-methods study protocol

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…A proxy can ll holes in the network left by age-related changes and life events (3,21). Creating a proxy in informal or formal care is an intervention applied by informal and formal care to organise contact and distance themselves from interaction in the network of informal caregivers (2). However, the proxy network is vulnerable because changes in the network are dependent on this often informal proxy.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Care Networks of Home-dwelling Older Persons in the Netherlands: Proof of Concept of a Network Typology

Kemper-Koebrugge¹,

Adriaansen²,

Laurant³

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

Background Studies on care networks of home-dwelling older persons often focus on network constellation. However, looking at network interaction can be helpful to improve the support generated by the care network. A European study on diabetes patients found network types based on the interaction within a network, which can be beneficial (generative, proxy) or detrimental (struggling, avoidant) to support. This study explored whether these network types are present in care networks of home-dwelling older persons in the Netherlands and how these network types manifest in constellation or ways of interaction (negotiation, navigation and contagion). Methods The present study is a secondary analysis of a cross‐sectional qualitative study of 16 care networks with home‐dwelling older persons, informal caregivers and formal care providers conducted between March and September 2016. First, navigation, negotiation and contagion were analysed for each network; then the network type was determined for each network. ResultsWe found nine proxy networks, four generative networks, two avoidant networks and one struggling network. In the proxy networks, all negotiation and navigation were centralised by the proxy. In generative networks, negotiation was possible if the older person could be reciprocal and the network supported this. In avoidant networks, informal and formal caregivers had to deal with an older person who refused support. In the struggling network, the underlying problem could not be addressed. Furthermore, two networks seemed to show a transition process from generative to proxy network.ConclusionWe concluded that the network typology on interaction offered extra information about the functioning of the care network. It seems that the network type can change over time, but more research is needed to confirm this. This study suggests that interventions in avoidant or struggling networks are difficult. Also actions were aimed at developing proxy networks. Interventions maintaining or developing generative networks seem underused.

show abstract

“…With ageing populations and spending cuts in public healthcare, western countries are increasingly focusing on ageing at home with support from a network that is comprised of the older adult’s social network with or without formal care providers [ 1 ]. Networks exhibit diversity in their constellations and the support they generate [ 2 – 4 ]. In order to improve the generated support from networks, it is important for formal care providers to know network composition and understand interaction processes in the network (network mechanisms).…”

Section: Introductionmentioning

confidence: 99%

Care networks of home-dwelling older adults in the Netherlands: proof of concept of a network typology

Kemper-Koebrugge,

Adriaansen,

Laurant

et al. 2023

BMC Geriatr

Self Cite

View full text Add to dashboard Cite

Background Studies on care networks of home-dwelling older adults often focus on network composition. However, looking at network mechanisms (negotiation, navigation and contagion) can be helpful to improve the support generated by the care network. A European study on diabetes patients identified network types based on interaction, which can be beneficial (generative, proxy) or detrimental (struggling, avoidant) to support. This study explored whether these network types are present in care networks of home-dwelling older adults in the Netherlands, and how these types manifest in composition or mechanisms. Methods The present study is a cross‐sectional qualitative study of care networks supporting 19 home‐dwelling older adults. Face-to-face interviews were conducted with the older adult and their informal and formal caregivers between March and September 2016. Network composition and mechanisms were abstracted from content analysis of interview transcripts, then network type was determined for each network. Results Three of the 19 networks had only one respondent and were excluded, yielding 16 for analysis: eight proxy networks, three generative networks, two avoidant networks, one struggling network, and two possibly hybrid networks. In the proxy networks, all negotiation and navigation were centralised by the proxy. In generative networks, negotiation was possible if the older adult could reciprocate, and the network supported this. In avoidant networks, informal and formal caregivers had to deal with an older adult who refused support. In the struggling network, the underlying problem could not be addressed. Furthermore, two networks could either be hybrid network types or networks in a transition process from generative to proxy network. Conclusion Our results suggest that the network typology developed in the context of diabetes patients is relevant and mostly replicable in networks of multi-morbid older adults. We found that a care network typology based on mechanisms offered additional information beyond network composition. It also appears that the network type can change over time, but more research is needed to confirm this. This study suggests that interventions in avoidant or struggling networks are difficult. Also, actions of network participants seemed aimed at developing proxy networks. Interventions designed to develop or maintain generative networks seem underused.

show abstract

Actions to influence the care network of home‐dwelling elderly people: A qualitative study

Cited by 9 publications

References 36 publications

Cooperation networks of ambulatory health care providers: exploration of mechanisms that influence coordination and uptake of recommended cardiovascular care (ExKoCare): a mixed-methods study protocol

Cooperation networks of ambulatory health care providers: exploration of mechanisms that influence coordination and uptake of recommended cardiovascular care (ExKoCare): a mixed-methods study protocol

Care Networks of Home-dwelling Older Persons in the Netherlands: Proof of Concept of a Network Typology

Care networks of home-dwelling older adults in the Netherlands: proof of concept of a network typology

Contact Info

Product

Resources

About