Experiences Of Healthcare Assistants Research Articles

Exploring healthcare assistants\u2019 role and experience in pain assessment and management for people with advanced dementia towards the end of life: a qualitative study

BackgroundPain assessment and management are key aspects in the care of people with dementia approaching the end of life but become challenging when patient self-report is impaired or unavailable. Best practice recommends the use of observational pain assessments for these patients; however, difficulties have been documented with health professionals’ use of these tools in the absence of additional collateral patient knowledge. No studies have explored the role, perspectives and experiences of healthcare assistants in pain assessment and management in dementia; this study provides insight into this important area.MethodsA qualitative approach was adopted, using key informant interviews with healthcare assistants caring for people with advanced dementia approaching the end of life in hospice, nursing home and acute care settings. Thematic analysis was the analytic approach taken to interpretation of interview data. Data were collected between June 2014 and September 2015.ResultsFourteen participants took part in the study. Participants’ average length of caring experience was 15.4 years and most were female. Three key themes emerged: recognising pain, reporting pain, and upskilling. Participants were often the first to notice obvious causes of pain and to detect changes in patient norms which signified hidden causes of pain. Comprehensive knowledge of resident norms enabled participants to observe for behavioural and nonverbal indicators of pain and distinguish these from non-pain related behaviours. Pain reporting was heavily impacted by relationships with professional staff and the extent to which participants felt valued in their role. Positive relationships resulted in comprehensive pain reports; negative relationships led to perfunctory or ambiguous reporting. Participants emphasised a desire for further training and upskilling, including in the use and reporting of basic pain tools.ConclusionsHealthcare assistants are frontline staff who have a key role in direct patient care, spending a considerable amount of time with patients in comparison to other health professionals. These staff are often first to notice changes in patients that may signify pain and to alert professional staff. However, to ensure the quality of these reports, further efforts must be made in reversing stigma attached to this role and in upskilling these members of the healthcare team.

"Sometimes I've gone home feeling that my voice hasn't been heard": a focus group study exploring the views and experiences of health care assistants when caring for dying residents.

BackgroundIn most developed countries, Health Care Assistants comprise a significant, and growing, proportion of the residential aged care workforce. Despite the fact that they provide the majority of direct care for residents, little is known about a key care aspect of their work, namely their experience of caring for dying residents.MethodsTwenty-six Health Care Assistants working in aged residential care facilities in Auckland, New Zealand participated in six focus group discussions. Focus groups were designed to explore the experiences of Health Care Assistants caring for imminently dying residents in aged care facilities and to identify barriers and facilitators to their work in this area. The focus groups were digitally recorded, transcribed verbatim and analysed using a general inductive approach.ResultsParticipants confirmed that Health Care Assistants provide the majority of hands on care to dying residents and believed they had a valuable role to play at this time due to their unique ‘familial’ relationship with residents and families. However, it was apparent that a number of barriers existed to them maximising their contribution to supporting dying residents, most notably the lack of value placed on their knowledge and experience by other members of the multidisciplinary team. Whilst a need for additional palliative and end of life care education was identified, a preference was identified for hands on education delivered by peers, rather than the didactic education they currently receive.ConclusionGiven ageing populations internationally coupled with a constrained health budget, the role of Health Care Assistants in most developed countries is likely to become even more significant in the short to medium term. This study makes a unique contribution to the international literature by identifying the barriers to caring for dying residents experienced by this valuable sector of the aged care workforce. These data have the potential to inform new, innovative, interventions to address the urgent need identified to improve palliative and end of life care management in aged care internationally.

The provision of emotional labour by health care assistants caring for dying cancer patients in the community: A qualitative study into the experiences of health care assistants and bereaved family carers

BackgroundWhile previous research has suggested that health care assistants supporting palliative care work in the community regard the provision of emotional labour as a key aspect of their role, little research has explored the experiences of family carers who are the recipients of such support. ObjectiveTo explore the emotional labour undertaken by health care assistants working in community palliative care from the perspectives of both health care assistants and bereaved family carers. DesignWe conducted a qualitative interview study in 2011–2012 with bereaved family carers of cancer patients who had received the services of health care assistants in the community, and health care assistants who provided community palliative care services. Transcripts were coded and analysed for emergent themes using a constant comparative technique. SettingsThree different research sites in the United Kingdom, all providing community palliative care. Participants and methodsSemi-structured interviews were conducted with 33 bereaved family carers and eight health care assistants. ResultsHealth care assistants view one of their key roles as providing emotional support to patients and their family carers, and family carers recognise and value this emotional support. Emotional support by health care assistants was demonstrated in three main ways: the relationships which health care assistants developed and maintained on the professional–personal boundary; the ability of health care assistants to negotiate clinical/domestic boundaries in the home; the ways in which health care assistants and family carers worked together to enable the patient to die at home. ConclusionThrough their emotional labour, health care assistants perform an important role in community palliative care which is greatly valued by family carers. While recent reports have highlighted potential dangers in the ambiguity of their role, any attempts to clarify the ‘boundaries’ of the health care assistant role should acknowledge the advantages health care assistants can bring in bridging potential gaps between healthcare professionals and family carers.

A year’s healthcare assistant experience as a prerequisite?

British Journal of NursingVol. 22, No. 9 Healthcare PolicyA year’s healthcare assistant experience as a prerequisite?Alan GlasperAlan GlasperSearch for more papers by this authorAlan GlasperPublished Online:16 Aug 2013https://doi.org/10.12968/bjon.2013.22.9.536AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Anon (2013) University sets psychometric test for child branch students. Nurs Standard 25(52): 6 Google ScholarButterworth T, Faugier J (1992) Clinical Supervision and Mentorship in Nursing. Chapman and Hall, London Crossref, Google ScholarCouncil of Deans of Health (2013). Press Release: Council of Deans of Health raises concerns over plans to require healthcare assistant experience for new student nurses, CDH, 26 March. http://www.councilofdeans.org.uk/ (accessed 22 April 2013) Google ScholarDepartment of Health (2004) The NHS Knowledge and Skills Framework (NHS KSF) and the Development Review Process. DH, London Google ScholarGlasper A (2013) A look into the future of nursing education in the UK. Br J Nurs 22(1): 58–9 Link, Google ScholarGlasper A (2012) Escaping the ivory tower: emancipation of the modern clinical academic. Br J Nurs 21(8):496–7. Link, Google ScholarMaben J, Macleod Clark J (1998) Project 2000 diplomates’ perceptions of their experiences of transition from student to staff nurse. J Clin Nurs 7(2): 145–53 Crossref, Medline, Google ScholarMason R (2013) Nurses spend too much time chatting, says Downing St patient tsar Ann Clywd. The Telegraph, 1 April. http://www.telegraph.co.uk/news/politics/9964858/Nurses-spend-too-much-time-chatting-says-Downing-Stpatient-tsar-Ann-Clywd.html (accessed 22 April 2013) Google ScholarMooney H (2009) UK’s largest NHS trust to test nurses for compassion. Nursing Times www.nursingtimes.net/whats-new-in-nursing/acute-care/uks-largest-nhs-trust-to-test-nurses-for-compassion/5000425.article) Google ScholarNursing and Midwifery Council (2008) Standards to Support Learning and Assessment in Practice. NMC, London Google ScholarRoyal College of Nursing (2012) Quality with Compassion:The Future of Nursing Education. Report of the Willis Commission 2012. RCN, London Google ScholarRoyal College of Nursing (2010) Guidance on safe nurse staffing levels in the UK. RCN, London Google ScholarScott H (2004) Are nurses “too clever to care” and “too posh to wash”? Br J Nurs 13(10): 581 Link, Google ScholarSmith JP (1994) Project 2000 assessed: is nursing education a means or an end? J Adv Nurs 19(3): 411 Crossref, Medline, Google ScholarWatson NA (1999) Mentoring today—the students’ views. An investigative case study of pre-registration nursing students’ experiences and perceptions of mentoring in one theory/ practice module of the Common Foundation Programme on a Project 2000 course. J Adv Nurs 29(1):254–62 Crossref, Medline, Google ScholarWilson-Barnett J, Butterworth T, White E,et al. (1995) Clinical support and the Project 2000 nursing student: factors influencing this process. J Adv Nurs 21(6):1152–8 Crossref, Medline, Google Scholar FiguresReferencesRelatedDetails 8 May 2013Volume 22Issue 9ISSN (print): 0966-0461ISSN (online): 2052-2819 Metrics History Published online 16 August 2013 Published in print 8 May 2013 Information© MA Healthcare LimitedPDF download

Health Care Assistants in Primary Care Depression Management: Role Perception, Burdening Factors, and Disease Conception

In primary care, the involvement of health care assistants (HCAs) in clinical depression management is an innovative approach. Little is known, however, about how HCAs experience their new tasks. We wanted to describe the perceptions and experiences of HCAs who provided case management to patients with depression in small primary care practices. This qualitative study was nested in the Primary Care Monitoring for Depressive Patients Trial on case management in Germany. We used a semi-structured instrument to interview 26 HCAs and undertook content analysis. We focussed on 3 key aspects: role perception, burdening factors, and disease conception. Most HCAs said their new role provided them with personal and professional enrichment, and they were interested in improving patient-communication skills. They saw their major function as interacting with the patient and considered support for the family physician to be of less importance. Even so, some saw their role as a communication facilitator between family physician and patient. Burdening factors implementing the new tasks were the increased workload, the work environment, and difficulties interacting with depressed patients. HCAs' disease conception of depression was heterogeneous. After 1 year HCAs believed they were sufficiently familiar with their duties as case managers in depression management. HCAs were willing to extend their professional responsibilities from administrative work to more patient-centred work. Even if HCAs perform only monitoring tasks within the case management concept, the resulting workload is a limiting factor.

Seconding healthcare assistants to a pre-registration nursing course

Attrition from traditional pre-registration nursing programmes in the United Kingdom continues to be substantial and, once qualified, new staff nurses experience a number of challenges in adapting to their new role. A possible solution, strongly favoured by the current government, is to second existing healthcare assistants onto pre-registration programmes. The premise is that, because of their previous caring experience and exposure to work in the National Health Service, secondees will be more committed to complete training and will undergo role transition more effectively. This paper presents an in-depth, qualitative study concerning the role transition of newly qualified staff nurses who had previously been employed as healthcare assistants. Uptake of the scheme had been substantially lower than anticipated, with only a small number of secondees eventually returning to their original wards. Secondees, their ward managers, percerptors and clinical practice facilitators were interviewed and the data were analysed employing the sequence for qualitative data analysis described by Miles and Huberman (1994). Findings suggest that healthcare-assistant secondment may not offer a ready solution to increasing the qualified nursing workforce. Contributory factors include: the length of time required for each newly qualified practitioner to qualify via the secondment route; the degree of commitment required on the part of secondees and university staff; the apparently limited benefits of previous healthcare-assistant experience; and personal costs to the secondees. Secondees described how they had been afraid of not completing the course successfully because of the public nature of failure if they were obliged to return to their original workplaces in the same role as before. This additional pressure has not been anticipated by proponents of secondment schemes and may help to explain why so few eligible candidates applied for secondment.