Disciplinary power and the process of training informal carers on stroke units

Sadler, Euan; Hawkins, Rebecca; Clarke, David; Godfrey, Mary; Dickerson, Josie; McKevitt, Christopher

doi:10.1111/1467-9566.12625

Cited by 2 publications

(1 citation statement)

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“…Historically, the relationships between professionals and informal care givers could be characterized as a 'silent' hierarchy rather that a collaborative relationship. This was not so much the subject of our research, but it can be an explanation for the fact that the relationships with informal caregivers are not naturally firmly maintained, which can make networks vulnerable [59,60].…”

Section: Number (%) Of Network Of Each Type In Which the Informal Camentioning

confidence: 95%

Professional Care Networks of Frail Older People: An Explorative Survey Study from the Patient Perspective

et al. 2020

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Key pointsPatient participation is high on the public agenda, but multidisciplinary teams who offer care to frail older people find it hard to incorporate patients views in their way of working. Our study focused on the care network of the older patient, and more specific on the role of the informal caregiver. In many networks, the informal caregiver was not or only moderately connected with professional actors. Elderly care networks can be rather vulnerable because the power (knowledge, contacts) lies entirely with the patient. Our study suggests that it would be relatively easy to develop materials to enable professionals to map the patient care network, which could then be used as the basis of conversations about the organisation of care, Background: Frail older people living in the community require multidisciplinary care. Despite the fact that patient participation is high on the public agenda, studies into multidisciplinary care mainly focus on the viewpoints of professionals. Little is known about frail older patients' experiences with care delivered by multidisciplinary teams and their perception of collaboration between professional and informal caregivers. Objective: To gain more insight into the experiences of frail older patients with integrated multidisciplinary care by mapping the care networks of this patient group and their perception of the interconnection between professional and informal caregivers. Methods: Survey study to facilitate a care network analysis. Due to the vulnerable health status of the respondents, questionnaires were completed during interviews. Analysis was performed using an iterative process, using both visual and metric techniques. Participants: 44 older persons, considered 'frail' by their general practitioner. Setting: Four general practices in The Netherlands. Results: The networks of the participants consisted of an average of 15 actors connected by 54 ties. General practitioners were the most common actors in the networks, and were well connected to medical specialists and in-home care providers. The participants did not always perceive a connection between their general practitioner and their informal caregiver. The network analyses resulted in the identification of three subtypes: simple star (n = 16), complex star (n = 16), and sub-group networks (n = 12). Conclusions: Our findings indicate that the elderly often do not experience the integration of multidisciplinary care as such. This is a real opportunity for MTs to improve their care and to make the patients' experiences better in line with what they are aiming: allowing patients to live at home as healthy and independently as possible for as long as possible. We showed that informal caregivers often form communication bridges between patients and professionals. Having a better knowledge of the patient perspective enables the gaps in professional care networks of frail older people to be filled and facilitates the anticipation of crisis situations.

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Section: Number (%) Of Network Of Each Type In Which the Informal Camentioning

confidence: 95%