Understanding eldercare users' views on quality of care and strategies for dealing with problems in Swedish home help services

Abstract

The aim of the present study was to gain a deeper understanding of eldercare users' strategies for dealing with problems in the quality of care and care satisfaction in relation to home help services. Based on earlier research and evaluations, it was assumed that users would express satisfaction and gratitude, and also be unwilling to complain. The specific research questions were: (i) What, if any, quality of care problems do the users mention? (ii) How do the users explain the reasons for these problems? and (iii) What strategies do the users employ to deal with these problems? A total of 35 interviews were conducted in November 2013 with 15 men and 20 women (66-92 years). The data were analysed using thematic and qualitative content analysis. The results showed that almost all users expressed overall satisfaction with their care. However, all but one also mentioned problems. The users stated very clearly and explicitly the reasons for these problems, and in most cases, they referred to the work conditions, work organisation and lack of other resources in the eldercare organisation. Two strategies were commonly used to deal with these problems: trivialisation and adaptation. A third strategy was expressed dissatisfaction, where the problem led to actions or plans to take action. One interpretation of the findings is that what is actually measured in official quality assessments and follow-ups may be care users' understanding of the work conditions and work organisation of eldercare. The understanding attitude may prevent care users from complaining because it lowers their expectations.

The inter-relationship of diversity principles for the enhanced participation of older people in their care: a qualitative study

“…Organisational support and time as identified by participants are intrinsically linked and impact on the environment within which health and aged care providers can establish and maintain rapport, thus enhancing the acceptability of services. Older people recognise how these affect the quality of care that is delivered [45]. The Thórarinsdóttir & Kristjánsson (2014) framework, mentioned above, purports that organisational values must recognise and embed respect and equity, key to active participation in care [27].…”

The Impact of Leadership and Psychosocial Work Environment on Recipient Satisfaction in Nursing Homes and Home Care

“…These results are in line with previous studies; better leadership creates a better psychosocial work environment (Dellve, Skagert, & Vilhelmsson, 2007; Lundgren et al, 2015), and a better psychosocial work environment generates better recipient satisfaction in nursing homes (Dellve, Skagert, & Vilhelmsson, 2007; Lundgren et al, 2018). Previous research has also shown that leadership and psychosocial work environment have less impact on recipient satisfaction in home care compared with in nursing homes (Dellve, Skagert, & Vilhelmsson, 2007; Lundgren et al, 2018; Westerberg et al, 2017). Only one significant association was found in home care (between direct leadership and psychosocial work environment).…”

“…These interpersonal aspects are, according to Bishop et al (2008), important due to their indirect effects on nursing assistants. Westerberg, Hjelte, and Josefsson (2017) have noted that influence does not have an effect on recipient satisfaction in home care because recipients do not believe they are included in the decision-making process about their care. Regarding different aspects of the psychosocial work environment, more role conflict and exhaustion and less job satisfaction have been associated with low recipient satisfaction (Tzeng, Ketefian, & Redman, 2002).…”

“…In these cases, the RN is responsible for determining that nursing assistants have the right prerequisites to perform the delegated tasks and have the responsibility for how they perform the delegated work tasks (National Board of Health and Welfare, 1997, 2017). Nursing assistants in home care help with activities such as facilitating activities of daily living (ADL), treating wounds, administering prescribed drugs and injections (insulin), and performing personal care in the private homes of the older person (Szebehely & Trydegard, 2012; Westerberg et al, 2017). The assistance varies in both in the content and the amount of the service, and the work done by nursing assistants greatly varies.…”

How Should the Social Service Quality Evaluation in South Korea Be Verified? Focusing on Community Care Services

“…The Facility Evaluation Department of the SSIS abolished the settlement disclosure item, integrated the accounting management item, and repealed the document filing index in the scheme research to improve the social service QE system in 2019. In addition, it was improved so that it now measures the satisfaction of both consumers and suppliers by adding provided manpower satisfaction to user satisfaction [ 30 ].…”