Home-and community-based care services: identifying consumers and needs in a rural Western Cape Province setting

Date
2016-12
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH SUMMARY : Background: Person-centredness is an aim of the Home- and Community-Based Care service, where users’ needs always take priority. Identifying users and their needs is vital to quality services. Objectives: The dual aims of the study were to determine who the Home and Community Based Carers in the study setting view as the consumers of their services, and to identify the needs of these consumers. Method: An explorative, qualitative study was done. Home and Community-Based Carers (n=5), patients (n=9) and family caregivers (n=5) providing or using the Home- and Community-Based Care service in Caledon (Western Cape, South Africa) participated in the study. Convenient sampling was done. Data was collected through a focus group discussion with the carers and semi-structured interviews with the users and family caregivers. Thematic analysis of data was done. All relevant information related to the study was explained to the participants and informed consent was obtained. The anonymity and confidentiality of all participants was protected throughout the study. Findings: The Home- and Community-Based Carers viewed the community as the users of their service. The community refers to the residents of Caledon as any resident could benefit from the service. Family involvement, privacy and relationship-building are crucial to Home- and Community-Based Care service in Caledon. Themes from user interviews included: user experience of the service; impact of the service; services received; communication breakdown and suggestions for improvement. Users were mostly satisfied with the service and found it acceptable. Their needs were being met, but they expressed a need for further training and guidance related to the management of specific health conditions. Findings indicated challenges with referral to other levels of health care. Users had recommendations on how the service could improve, for example longer working hours, employing male caregivers, consistency of service delivery and increasing the stipend that the carers are currently earning. Conclusion: The Home- and Community-Based Carers provided a valuable service to the entire community of Caledon. The needs of the users were mostly met and most users had a positive experience of the service. The study identified gaps related to further education, interaction with family carers and referral to other services. Recommendations: Recommendations include: the development of a contact platform with clinic staff; education of Home- and Community-Based Carers on referral pathways and sources of support; developing or use of scope of practice guidelines; training on specific health conditions and practical suggestions that might improve working conditions.
AFRIKAANSE OPSOMMING : Agtergrond: Persoon-gesentreerdheid is ’n doelwit van die Tuis en Gemeenskap Gebaseerde Versorgings dienste waar die verbruiker se behoeftes altyd geprioritiseer word. Identifisering van verbruikers en hulle behoeftes is noodsaalik vir kwaliteit dienste. Doelwitte: Die doelwitte van die studie was om te bepaal wie die Tuis en Gemeenskap Gebaseerde Versorgers sien as die verbruikers van hulle dienste, en om die behoeftes van die verbruikers te bepaal. Metodologie: Die studie was ondersoekend en kwalitatief van aard. Tuis en Gemeenskapversorgers (n=5), pasiente (n=9) en familie versorgers (n=5) wat versorging bied of gebruik maak van die Tuis en Gemeenskaps Gebaseerde Versorgings dienste in Caledon in die Wes-Kaap, het deelgeneem aan die studie. Toevallige steekproefneming is gedoen. Data was ingesamel deur ’n fokus groep bespreking met die Tuis en Gemeenskaps Gebaseerde Versorgers en semi-gestruktueerde onderhoude met verbruikers en familie versorgers. Tematiese analise van data is gedoen. Alle relevante infromasie rakende die studie was verduidelik aan die deelnemers en hulle het die reg gehad om die weier om deel te neem aan die studie. Deelnemers is meegedeel dat hulle anoniem sal bly en dat alle data vertroulik gehanteer sal word. Bevindinge: Die bevindinge het aangedui dat die Tuis en Gemeenskaps Gebaseerde Versorgers die gemeenskap as die verbruikers van hulle diens sien. Die gemeenskap verwys na die inwoners van Caledon aangesien enige inwoner kan baatvind by die dienste. Familie betrokkenheid, privaatheid en die bou van verhoudings is belangrik vir die Tuis en Gemeenskaps Gebaseerde Versorgings dienste in Caledon. Temas vanuit verbruiker onderhoude sluit in: verbruikers se ondervindinge van die diens, impak van die diens, dienste ontvang, kommunikasie afbreuk en aanbevelings vir verbetering. Die meeste vebruikers was tevrede met die diens en het dit aanvaarbaar gevind. Hulle behoeftes is bevredig, maar hulle het ’n behoefte vir verdere opleiding en leiding rakende die hantering van spesifieke mediese kondisies. Die bevindinge dui op uitdagings met die verwysing na ander vlakke van gesondheids sorg. Verbruikers het aanbevelings gemaak rakende diensverbeterings byvoorbeeld langer werks ure, aanstel van manlike versorgers, konstantheid van diens lewering en die verhoging van die lone wat die Tuis en Gemeenskaps Gebaseerde versorgers hulle verdien. Opsomming: Die Tuis en Gemeenskaps Gebaseerde Versorgings dienste lewer ’n waardevolle diens aan die hele gemeenskap in Caledon. Die behoeftes van die verbruiker is bevredig en die meerderheid van die verbruikers het die diens as positief ervaar. Die studie het ook leemtes geidentifiseer rakende verdere opleiding, interaksie met familie versorgers en verwysing na ander dienste. Aanbevelings: Aanbevelings sluit in die ontwikkeling van ’n kontak platform met die kliniekpersoneel; opleiding van Tuis en Gemeenskaps Gebaseerde Versorgers rakende verwysings-prosedure en bronne van ondersteuning; ontwikkeling en of gebruik van omvang van praktyk riglyne; opleiding oor spesifieke gesondheids toestande en praktiese aanbevelings wat werksomstandighede mag verbeter.
Description
Thesis (MHumanRehabSt)--Stellenbosch University, 2016.
Keywords
Patient-centered health care -- Western Cape (South Africa), Medical care -- Needs assessment -- Western Cape (South Africa), Home and community-based services, UCTD
Citation