Between principles and pragmatism – primary healthcare and social services professionals’ experiences and perceptions of self-care for older adults with home care: a qualitative study
Creators: name: Dohrn, Ing-Mari
name: von Berens, Åsa
name: Olsson, Christina B.
name: Rydwik, Elisabeth
name: Jakobsson, Elin
name: Palmlöf, Lina
Publisher: name: Taylor & Francis
Year: 2024
Subjects: Environmental Sciences not elsewhere classified
Biological Sciences not elsewhere classified
Science Policy

description: To explore the experiences of healthcare and social services professionals and their perceptions of using Certificate for self-care with support (CSS) for preventive self-care for older adults with home care, including the CSS process and collaborations between primary healthcare and social services. An inductive qualitative study including seven focus group interviews analyzed with reflexive thematic analysis. The study was conducted in the Stockholm Region 2022/23. In total, 23 informants were recruited from four key partners involved in the CSS process: professionals from primary care rehabilitation and primary healthcare, social services officers, and home care staff. The analyses resulted in five interconnected themes: ‘Guidelines with scope for interpretation,’ ‘Support for self-care is needed, but complicated in practice,’ ‘To trust the other professions’ competence,’ ‘There is a transfer of responsibility,’ and ‘Communication is key.’ The overarching theme ‘Principles or pragmatism for safe person-centered care,’ anchoring the other themes, revealed a common goal of achieving safe and individualized care within available resources, but from two conflicting perspectives: the importance of following the process according to the guidelines or taking a more pragmatic approach. This study highlights the need to establish structures facilitating safe self-care among frail groups, such as older persons dependent on home care. Our findings emphasize that the demarcation between, and responsibilities of, organizations need to be discussed and clarified to offer person-centered support. Comprehensible guidelines and functioning communication channels must be established so that all important perspectives can be heard, not least the patient’s. The support of a patient’s self-care is an important part of health promotion and preventive efforts.Collaboration between social services and healthcare services is crucial when supporting an older person in performing their self-care.The boundaries and responsibilities of organizations regarding person-centered support for self-care need to be discussed and clarified.Clear guidelines and functioning communication channels must be established to ensure all important perspectives are heard, especially the patient’s. The support of a patient’s self-care is an important part of health promotion and preventive efforts. Collaboration between social services and healthcare services is crucial when supporting an older person in performing their self-care. The boundaries and responsibilities of organizations regarding person-centered support for self-care need to be discussed and clarified. Clear guidelines and functioning communication channels must be established to ensure all important perspectives are heard, especially the patient’s.