Key result
Home health care clinicians identified clinician-caregiver communication, accuracy of hospital discharge information, and access to resources as the most salient factors affecting family caregiver training.
Why the study?
Family caregiver training needs often go unmet during home health care, yet there is a critical knowledge gap regarding challenges clinicians face in providing this training.
Observational (n=19)
Yes
Home health care clinicians face individual, interpersonal, and structural barriers to delivering family caregiver training, highlighting the need for updated reimbursement structures and improved hospital-home health communication.
May warrant attention to communication, discharge accuracy, and resources in home health caregiver training; leaves open effective implementation strategies.
BACKGROUND: During Medicare home health care (HHC), family caregiver assistance is often integral to implementing the care plan and avoiding readmission. Family caregiver training delivered by HHC clinicians (nurses and physical therapists [PTs]) helps ensure caregivers' ability to safely assist when HHC staff are not present. Yet, family caregiver training needs often go unmet during HHC, increasing the risk of adverse patient outcomes. There is a critical knowledge gap regarding challenges HHC clinicians face in providing necessary family caregiver training. METHODS: Multisite qualitative study using semi-structured, in-depth key informant interviews with Registered Nurses (n = 11) and PTs (n = 8) employed by four HHC agencies. Participating agencies were diverse in rurality, scale, ownership, and geographic region. Key informant interviews were audio-recorded, transcribed, and analyzed using directed content analysis to identify existing facilitators and barriers to family caregiver training during HHC. RESULTS: Clinicians had an average of 9.3 years (range = 1.5-23 years) experience in HHC, an average age of 45.1 years (range = 28-63 years), and 95% were female. Clinicians identified facilitators and barriers to providing family caregiver training at the individual, interpersonal, and structural levels. The most salient factors included clinician-caregiver communication and rapport, accuracy of hospital discharge information, and access to resources such as additional visits and social work consultation. Clinicians noted the COVID-19 pandemic introduced additional challenges to providing family caregiver training, including caregivers' reduced access to hospital staff prior to discharge. CONCLUSIONS: HHC clinicians identified a range of barriers and facilitators to delivering family caregiver training during HHC; particularly highlighting the role of clinician-caregiver communication. To support caregiver training in this setting, there is a need for updated reimbursement structures supporting greater visit flexibility, improved discharge communication between hospital and HHC, and structured communication aids to facilitate caregiver engagement and assessment.
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Burgdorf et al. (2022) conducted an observational in Home health care (n=19). Family caregiver training delivery was evaluated on Facilitators and barriers to family caregiver training. Home health care clinicians identified clinician-caregiver communication, accuracy of hospital discharge information, and access to resources as the most salient factors affecting family caregiver training.
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