Examining dual roles in long-term-care homes in rural Alberta: a qualitative study
| Autor: | Shannon Spenceley, Sienna Caspar, Carly-Ann Haney, Julia Brassolotto |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Rural Population
Emergency Medical Services Canada Health (social science) Health Personnel lcsh:Special situations and conditions Medicine (miscellaneous) Qualitative property Care provision Alberta Professional boundaries Health care Humans dual roles Sociology Qualitative Research business.industry lcsh:RC952-1245 lcsh:Public aspects of medicine Public Health Environmental and Occupational Health lcsh:RA1-1270 Public relations Long-term care dual relationships long-term care Care work multiple relationships Thematic analysis business Qualitative research |
| Zdroj: | Rural and Remote Health, Vol 21 (2021) |
| ISSN: | 1445-6354 |
| Popis: | Introduction: In rural settings, many healthcare professionals experience intersections of professional and personal relationships, often known as dual roles. Dual roles are traditionally studied in terms of their potential for ethical conflicts or negative effects on care. In the existing scholarship, there is little discussion of dual roles in long-term care (LTC) settings, which present distinct conditions for care. Unlike other forms of health care, LTC work is provided daily, over longer periods, in care recipients' home environments. This article outlines results from a case study of LTC in rural Alberta, Canada and provides evidence of some of the challenges and, more notably, the considerable benefits of dual roles in these settings. Methods: The qualitative data discussed in this article come from a multi-site comparative case study of rural LTC that, among other questions, asked, 'How do personal and professional lives intersect in rural LTC settings across the province?' These data were collected through the use of rapid ethnographies at three rural LTC homes across the province of Alberta. The research team conducted semi-structured, in-depth interviews (n=90) and field observations (~200 hours). Participants were asked about care team dynamics, the organization of care work, the role of the LTC home in the community, and the intersections of public and private lives. The results were coded and critically analyzed using thematic analysis. Results: Dual roles were primarily described as beneficial for care provision. In many cases, dual roles provided participants with opportunities for reciprocity, enhanced person-centered care, and increased perceptions of trust and community accountability. Similar to what has been documented in the extant literature, dual roles also presented some challenges regarding personal and professional boundaries for those in leadership. However, the negative examples were outweighed by positive accounts of how dual roles can serve as a potential asset of rural LTC. Conclusion: There is a need for more nuanced conversations around the implications of dual roles. Policies and care approaches need to emphasize and support the use of good judgment and the responsible navigation of dual roles, rather than taking either a permissive or prohibitive approach. Leaders in rural LTC can promote conversations among care providers, with an emphasis on the cultural context of care provision and how dual roles play out in their specific professional practice. Blanket policies or educational approaches that frame dual roles as necessarily problematic are not only insensitive to the unique nature of rural LTC, but prohibitive of relational elements that these results suggest are highly supportive of person-centered care. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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