What personal support workers need to support older adults in making informed and shared decisions within home care teams
Notice bibliographique
Résumé
Background: Personal support workers (PSWs) are the largest group of home care providers who can play a pivotal role in helping their vulnerable older clients in making informed and shared decisions together with their home care teams. Shared decision making refers to a process whereby individuals and their care teams make health care choices together.[] Despite the many benefits of shared decision making (SDM), vulnerable older adults in the home care setting have been reported as less likely to experience SDM when faced with health and social care decisions.[2] Approach: We report on a qualitative analysis of textual data collected from a web-based survey of home care providers.[3] Our focus on analyzing data from PSWs is aimed at informing what PSWs need to support vulnerable older adults in making informed and shared decisions within home care teams. This study is part of a broader research program on what older adults, caregivers and interdisciplinary care team members need to support shared decision making.[4,5] Participants were recruited from a Canadian home care organization, SE Health. Participants were offered an opportunity to enter a draw for a $20 gift card. A participatory advisory group of one older adult, one caregiver and two care providers guided the research process (including study protocol review, survey development, data collection and analysis process). Training was provided as required to support their active participation as part of the research team. Ethics approval was obtained from the University of Laval, Quebec, and Southlake Regional Health Center, Ontario. Results: Our participants (personal support workers) were predominantly represented by older women with extensive home care experience (n=372, female = 92%, over 40 years of age = 67%, over 0 years of home care experience = 40%). Staying within their scope of practice our participants did not always perceive their distinct role in supporting vulnerable older adults with making decisions. Yet, as the trusted care provider whom vulnerable older adults rely on for support, they perceive themselves as understanding the personal situations of their clients. Situational challenges (such as the expectation to follow care plans as determined by nurse supervisors/case managers) may limit their ability to fully participate as care team members to voice the perspectives of their clients. Implications: Although front-line PSWs might best understand the situation of their clients, situational challenges can limit their ability to fully participate on care teams and voice the perspective of their older clients. Our study highlights the need for further research on the role of personal support workers in supporting shared decision making within care teams. References: Charles C, et al. Shared decision-making in the medical encounter: what does it mean? (or it takes at least two to tango). Soc Sci Med997 DOI: https://doi.org/0.06/s0277-9536(96)0022-32) Haesebaert, J., Adekpedjou, R., Croteau, J., Robitaille, H., Legare, F. (209) Shared decision-making experienced by Canadians facing health care decisions: a Web-based survey. CMAJ Open 7(2) DOI: https://doi.org/0.9778/cmajo.20802023) Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005 Nov;5(9):277-88. DOI: https://doi.org/0.77/0497323052766874) Lai C, Holyoke P, Plourde KV, D cary S, LgarF. What older adults and their caregivers need for making better health-related decisions at home: a participatory mixed methods protocol. BMJ open. 2020 Nov ;0():e03902. DOI: https://doi.org/0.36/bmjopen-2020-039025) Lai C, Holyoke P, Plourde KV, Yeung L, LgarF. Home care providers' perceptions of shared decision‐making with older clients (and their caregivers): A cross‐sectional study. Nursing Health Sciences. 2022 Jun;24(2):487-98. DOI: https://doi.org/0./nhs.2946
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,012 | 0,043 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,007 | 0,003 |
| Communication savante | 0,007 | 0,009 |
| Science ouverte | 0,002 | 0,005 |
| Intégrité de la recherche | 0,003 | 0,004 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,006 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».