Caregivers’ engagement during in‐hospital care of sABI’s patients: Evaluation of informal co‐production from the health providers’ perspective

Abstract

One of the challenges of providing healthcare services is to enhance its value (for patients, staff and the service) by integrating the informal caregivers into the care process, both concretely managing their patient's health conditions and treatment (co-executing) and participating in the whole healthcare process (co-planning). This study aims at exploring the co-production contribution to the healthcare process, analysing whether and how it is related to higher caregivers' satisfaction with service care and reduced staff burnout, in the eyes of the staff. It also investigated two possible factors supporting caregivers in their role of co-producers, namely relationship among staff and informal caregivers related to knowledge sharing (i.e. an ability determinant supporting co-production) and related to role social conflict (i.e. a willingness determinant reducing co-production). Results of a structural equation model on a sample of 119 healthcare providers employed by neurorehabilitation centers in Italy with severe acquired brain injury confirmed that knowledge sharing positively related with caregivers' co-executing and co-planning. Also, social role conflict was negatively related with co-executing but positively with co-planning. Furthermore, co-planning resulted in being unrelated to both outcomes, whereas co-executing was associated with caregivers' satisfaction, as measured by staff perceptions. Overall, our data provided initial empirical evidence supporting the ability of the determinant's contribution in allowing informal caregivers to assume an active role in both co-production domains. Furthermore, as expected, the role of conflict willingness determinant was found to be a hindering factor for co-executing but, conversely, a trigger for co-planning. This result should be considered more carefully in future studies.

Co-Production Performance Evaluation in Healthcare. A Systematic Review of Methods, Tools and Metrics

“…Only 17% of the investigated outcomes considered the professionals' perspective. Staff well-being and empathy/attitude are more widely analysed (e.g., [46,88,93,94,101]), thanks to well-known international scales targeting these issues. Public metrics assessing the type of outcome are limited in number and do not add valuable and innovative insights to health findings (e.g., [100]).…”

“…Finamore et al (2020) applied the MBI to verify the effect of co-produced personality disorder training on staff [93]. The same scale was used in Farnese et al (2020) to investigate the effects of informal co-production between professionals and caregivers, but no correlation was found [94].…”

“…Other behaviour/attitude changes include (improved) compliance, explained as the extent to which patients (or other lay actors) follow service provider's instructions, decisional conflict, that is, a state of uncertainty about the actions to be taken or opinions to be expressed, or a change in life routine (e.g., eating style). They have been assessed mainly in the health domain, with a validated scale or ad hoc adapted instruments (e.g., [81,94]). Some indicators are also adopted (e.g., [72,135]).…”

Co-creation in healthcare: framing the outcomes and their determinants

“…(2017) and van der Meer et al. (2018), whereas Farnese et al. (2020) reported that none of the CC dimensions analyzed were related to burnout.…”

“…The effects on caregivers have been little investigated compared to those on patients, although they play a crucial role in the CC of care, especially when healthcare users are in fragile clinical conditions. CC is related to higher satisfaction with caregivers' services (Farnese et al. , 2020; Suárez-Álvarez et al.…”