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A model of home-based care for people with disabilities : Better practice in rural Thailand

- Wanaratwichit, Civilaiz, Hills, Danny, Cruickshank, Mary, Newman, Barbara

  • Authors: Wanaratwichit, Civilaiz , Hills, Danny , Cruickshank, Mary , Newman, Barbara
  • Date: 2015
  • Type: Text , Journal article
  • Relation: Asia Pacific Journal of Health Management Vol. 10, no. 2 (2015), p. 44-51
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  • Description: Background and objective: People with disabilities living in rural areas often require considerable support to meet their complex needs. This study investigated a best practice model in home-based care for people with disabilities in rural Thailand.

    Design and Setting: A case study method was adopted to investigate a best practice model of home-based care for people with disabilities in Nakhonthai District, Phitsanulok Province, Thailand. Data were collected from 30 participants through in-depth interviews, focus groups, direct observation and document analysis. Content and thematic analyses were conducted for qualitative data. The Wilcoxon Signed-Rank test was used for the outcome measurement of activities of daily living (ADL) scores.

    Results: This model of home-based care for people with disabilities, as an integrated network model, brings together the community, health professionals and other organisations. The role of trained community health volunteers was mainly to deliver home-based personal care for people with disabilities, while health professionals focused mainly on controlling the quality of care, managing the knowledge and skills of volunteers, and co-ordinating the network. The difference between ADL scores before and after the implementation of the model (n=20) was statistically significant (p<0.01). Conclusion: This best practice model of home-based care for people with disabilities in rural Thailand shifts responsibility in the main service decisions from professionals to the community and other stakeholders and engages and empowered all stakeholders in the provision, co-ordination and management of care.

Home-based care for people with disabilities : role of registered nurses within the district health system in Thailand

- Wanaratwichit, Civilaiz, Hills, Danny, Cruickshank, Mary

  • Authors: Wanaratwichit, Civilaiz , Hills, Danny , Cruickshank, Mary
  • Date: 2020
  • Type: Text , Journal article
  • Relation: Collegian Vol. 27, no. 1 (2020), p. 18-22
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  • Description: Background: In Thailand, the number of people with physical disabilities (PwD) has been increasing. Following sweeping health care reforms in 2002, efforts were made to improve accessibility to health care by greatly increasing the number of Registered Nurses (RNs) working in local community health centres. Little is known, however, about the role of RNs in improving accessibility to home-based care and the outcomes of care for PwD in Thailand. Aim: To explore the role of RNs in providing high quality home-based services for PwD who have severe limitations in movement. Methods: A case study design was used to explore and describe the role of RNs in home-based care for PwD in one rural and one urban area in lower north Thailand. There were 73 participants, including PwD and their family members, community health volunteers, primary care providers, local government officers and members of the District Health management team. Data were collected from in-depth interviews and focus groups, which were analysed using thematic analysis. Results: The roles of RNs in home-based care for PwD were found in four domains, as case manager, rehabilitation care provider, manager of the community health volunteers and broader care coordinator. Conclusion: The full scope of the RN role in the provision of home-based care for PwD, in the district health system of Thailand, not only involves direct nursing care. The role also encompasses planning and co-ordination of the broad range of professional and non-professional services to meet the needs of PwDs in rural and urban settings. © 2019 Australian College of Nursing Ltd

Being a parent, but not : a grounded theory of home-based care

- Cooper, Kimberlea, Sadowski, Christina, Townsend, Rob

  • Authors: Cooper, Kimberlea , Sadowski, Christina , Townsend, Rob
  • Date: 2024
  • Type: Text , Journal article
  • Relation: Family Relations Vol. 73, no. 3 (2024), p. 1880-1898
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  • Description: Objective: This constructivist-grounded-theory study explored how foster and kinship carers conceptualize and experience their role. Background: Internationally, amid growing emphasis on home-based care for children and young people living outside parental care, issues such as carer shortages, dissatisfied carers, and placement instability present significant challenges. Method: Sixteen carers (seven foster carers and nine kinship carers) from a regional area in Victoria, Australia, participated in in-depth interviews following constructivist-grounded-theory protocols. Results: Six categories reveal the central ways carers go about caring for children and young people and the main challenges they face in doing so. The core category of “being a parent, but not” demonstrates tensions that carers experience in trying to establish a sense of belonging and connectedness with a child, within the limits of the Victorian home-based care system. Conclusion: Home-based carers view their role through a parental lens, but with various limitations that restrict their sense of being a parent. Implications: The current research acknowledges the role tensions inherent within the Victorian home-based care system and emphasizes the importance of raising the status of foster and kinship carers to provide more recognition of the expertise they hold in the care of children and young people within this complex context. © 2023 The Authors. Family Relations published by Wiley Periodicals LLC on behalf of National Council on Family Relations.
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