Home Healthcare and Family Responsibility: A Critical Discourse Analysis of Talk and Text
Bibliographic record
Abstract
This paper addresses how families' roles and responsibility for care are constructed within home health (in contrast to the responsibility of home health). A discourse analysis informed by a critical theoretical approach was used to analyze qualitative interviews with 13 home health managers and clinical leaders in British Columbia, alongside home care documents. When referring to family involvement, there was an emphasis on the importance of supporting a client's choice to stay at home. Government and agency documents describe family members as primary providers, with home health having a supplementary role. Agencies seek to avoid "substituting" for family care. Family responsibility is characterized as having both moral and structural value. Nonetheless, some participants advocated flexibility and recognized potential caregiving challenges. Data provide examples of how agency expectations are communicated to clients and families and become embedded within practice and policy. Findings are viewed within the broader organizational context as representing the "responsibilization" of support.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.023 | 0.029 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.007 | 0.005 |
| Science and technology studies | 0.013 | 0.024 |
| Scholarly communication | 0.011 | 0.013 |
| Open science | 0.002 | 0.008 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".