Task-shifting in Home Health Care - Multiple case study of health care tasks shifted to patients.: Multiple case study of health care tasks shifted to patients.

Jacobsen, Anja Marie Lundin

4. term

Techno-Anthropology, Master

2021

2021-06-04

60 pages

Introduction: This thesis addresses the phenomenon of task-shifting from health care professionals to patients when treatment tasks are performed in patient homes. 3 cases were selected to represent different layers of shifted tasks. Methods and theoretical framework: The project followed a multiple case-based approach. Semi-structured interviews we conducted with health care professionals and patients in the 3 cases. The analytical framework was composed of conceptions of treatment responsibility and quality with the task-shifting phenomenon as an overarching theme. Theoretical input on homes by Winther (2006), Heidegger (1951) and Douglas (1991) were used. Care theories proposed by Mol (2008,2010) and Pols (2010,2012) concerning active, tinkering patients and the notion of care teams were applied and conceptions on scaffolding by Botin (2020) & Botin et al. (2015,2016) were utilised to conclude the insights gained. Conclusions: The 3 cases revealed both differences and similarities in regards to treatment quality and treatment responsibility. Regardless of the types of tasks shifted, instruction played a large role in patient understandings of quality assurance processes. Patients take calculated risks as part of their daily life and health care professionals balance risks of adverse health care events with the incentives for sending patients home. A key incentive is QoL as measured or felt by healthcare professionals and patients, respectively, and a key measure assuring the quality of home health treatment is the reporting of adverse health care events. QoL is increased because of the mobility achieved by sending patients home with portable technologies. The weight of responsibility is especially heavy when communicating with health care professionals who do not understand or attempt to comprehend the extent of a patients’ specialised treatment and needs. Patients were seen to take on the role-responsibility needed to responsibly handle their home treatment, however, in situations where the responsibility is refused or deemed irresponsibly placed, the primary care sector can be engaged. Some patients expressed a sense of moral responsibility to ensure the quality of their medicine and to not waste the resources given to them. Homes can be rebuilt to fit treatment-related items and adaptive aids, as there is some importance to the home not resembling a hospital. Rebuilding requires planning for the collective good with co-dwellers. Health care professionals, family and devices contribute in different ways as important members of the care team, and networks can be consulted to strengthen the assembly of the team.

Task-shifting ; Home Health Care ; Multiple case study ; Responsibility ; Quality ; Care ; Home

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