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Teaming up to traverse loneliness: a co-creative journey toward a home care work model for supporting social participation among older adults
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.ORCID iD: 0000-0002-0729-5361
Umeå University, Faculty of Social Sciences, Department of Sociology.ORCID iD: 0000-0003-1975-9060
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.ORCID iD: 0000-0002-8265-5769
2022 (English)In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 22, no 1, article id 1159Article in journal (Refereed) Published
Abstract [en]

Background: Participatory research is particularly suitable in adressing know-do gaps in health systems. There is a disparity between what is known about the benefits of social participation and home care’s responsibility to provide conditions amenable to older adults’ social participation, and what is accomplished in home care practice. Home care workers are a large, low-power group, whose competences should be better harnessed. We carried out a participatory action research (PAR) project with the goal of generating an improved structure for identifying and alleviating loneliness. This article aims to explore the co-creative process of designing a work model that guides home care workers in supporting social participation among older care recipients.

Methods: Multimodal data from 16 PAR workshops with 14 home care workers were described and explored through the ‘recursive PAR process’ and the ‘framework for occupational enablement for change in community practice”.

Results. The PAR process is outlined through the objectives, activities, and work model, as well as enablement strategies employed throughout the PAR process; as are its opportunities, challenges and implications. The work model describes how care workers can act as discoverers of care recipients’ unmet social needs, employ intentional communication, and link to relevant professions or community services to alleviate loneliness among older home care recipients.

Conclusions: This research process included opportunities of collaborating with enthusiastic and competent home care workers, but also challenges of moving between theory and practice and maintaining active participation between workshops. The resulting work model is in step with the requirements of elderly care, is unique in its field and could comprise a first step toward a more systematic approach of assessing and addressing loneliness. The vivid delineation of the PAR process provided in this paper can aid other researchers in navigating participatory research in home care contexts.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2022. Vol. 22, no 1, article id 1159
Keywords [en]
Home care services, Participatory action research, Older adults, Social participation, Togetherness, Occupational therapy, Elderly care
National Category
Nursing Occupational Therapy Social Work
Research subject
Occupational therapy
Identifiers
URN: urn:nbn:se:umu:diva-199863DOI: 10.1186/s12913-022-08524-yISI: 000855171800003PubMedID: 36104816Scopus ID: 2-s2.0-85137850818OAI: oai:DiVA.org:umu-199863DiVA, id: diva2:1700233
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016- 07089Available from: 2022-09-30 Created: 2022-09-30 Last updated: 2023-04-03Bibliographically approved
In thesis
1. Harnessing togetherness: perceptions of loneliness and promotion of social participation in the home care context
Open this publication in new window or tab >>Harnessing togetherness: perceptions of loneliness and promotion of social participation in the home care context
2023 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Att fånga känslan av gemenskap : uppfattningar av ensamhet och främjande av social delaktighet i hemtjänstkontext
Abstract [en]

Introduction: It is well known that older adults have a higher risk for loneliness, which is detrimental to health. Home care in Sweden has a responsibility to address social needs, but systematic approaches are lacking and there is a know–do gap. The overall aim of this thesis was to develop knowledge about older home care recipients’ and home care providers' perceptions of loneliness and social participation among older adults, and furthermore, to develop a work model for supporting social participation in home care and explore that process.

Methods: Four studies were included. In the first study, care recipient interviews explored perceptions of social participation. In the second, a total population survey investigated the association between perceived care quality and loneliness. The third study used individual and group interviews with home care providers to explore discourses on loneliness and social support. The fourth applied a participatory action research(PAR) process with care workers to develop strategies to alleviate care recipients’ loneliness.

Findings: Enjoying personally relevant occupations, both in solitude and with others, was found to be important for satisfactory social participation. Low perceived quality in home care quality was statistically associated with loneliness. Two discourses, one in which care recipients were described as valued but vulnerable “others”, and another in which they were described as competent peers, were identified. A work model facilitating social participation was created, and the process was applied to a “framework for occupational enablement for change in community practice”.

Conclusion: The understanding of loneliness and social participation in the complex home care context has been nuanced, as have discourses that affect home care practice. The work model itself could become a first step towards systematically addressing loneliness and social needs, and the application of an occupational enablement framework onto the PAR process ties the methodologies together and facilitates participatory research for occupational therapy and science.

Place, publisher, year, edition, pages
Umeå: Umeå University, 2023. p. 100
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 2236
Keywords
Loneliness, Older adults, Home care services, Home care delivery, Social participation
National Category
Social Work Occupational Therapy Nursing
Research subject
Occupational therapy
Identifiers
urn:nbn:se:umu:diva-206318 (URN)978-91-8070-043-6 (ISBN)978-91-8070-044-3 (ISBN)
Public defence
2023-04-28, Rotundan, Universumhuset, Universums gränd 8, Umeå, 09:00 (Swedish)
Opponent
Supervisors
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-07089
Available from: 2023-04-06 Created: 2023-04-03 Last updated: 2023-04-04Bibliographically approved

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Nordin, ThereseCoe, Anna-BrittNilsson, Ingeborg

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