Live-in-Versorgung in Deutschland: eine qualitative Inhaltsanalyse gesellschaftlicher und politischer Diskurse

Adele Grenz , Mark Schweda , Milena von Kutzleben
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Abstract

Background

In Germany, Eastern European live-in carers are filling a gap in home-based long-term care for older persons. As a care reality fraught with diverse problems, live-in care is an unregulated care format bordering between formal and informal structures and has so far received little attention from health services research. The aim of the qualitative study described here was to analyze the current discourses among stakeholders from care practice, politics, and associations, as well as the arguments contained therein regarding the status quo and future of live-in care.

Methods

We analyzed 22 online available documents from stakeholders, such as statements and contributions to the discussion, as well as ten expert interviews. Within the scope of a qualitative content analysis, triangulation of the two data corpora was conducted. Using a deductive-inductively developed system of categories, viewpoints and arguments were analyzed on this basis.

Results

Three arguments regarding the future regulation of live-in care were identified in current socio-political discourses: 1) Maintain: professionalization of live-in care, 2) Supplement: integrating live-in care into the care mix, 3) Abolish: alternatives to the live-in care model. Despite different perspectives regarding the implementation of live-in care in the long-term care system, there is consensus that political measures must move beyond purely legal solutions. Regulation of framework conditions, mediation, and care practices is necessary.

Discussion and Conclusion

Regarding the future design of live-in care, particular emphasis is placed on adjusted financial incentives, professionalized live-in and live-out services, as well as the organization and promotion of informal care networks and collaborations with formal providers like outpatient services as key levers. In a broader discourse on the regulation of live-in care, it should be clarified how requirements for quality-assured long-term care can be applied, taking into account the needs of care arrangements.
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[德国的居家护理:社会和政治话语的定性内容分析]。
背景:在德国,东欧的住家照顾者正在填补以家庭为基础的老年人长期照顾的空白。作为一种充满各种问题的护理现实,住家护理是一种介于正式和非正式结构之间的不受管制的护理形式,迄今为止很少受到卫生服务研究的关注。这里描述的定性研究的目的是分析来自护理实践,政治和协会的利益相关者之间的当前话语,以及其中包含的关于生活护理的现状和未来的争论。方法:我们分析了来自利益相关者的22个在线可用文件,如声明和对讨论的贡献,以及10个专家访谈。在定性内容分析的范围内,对两个数据语料库进行了三角剖分。运用演绎-归纳发展的范畴体系,在此基础上分析观点和论证。结果:在当前的社会政治话语中,确定了关于未来生活护理监管的三个论点:1)维持:生活护理的专业化;2)补充:将生活护理纳入护理组合;3)废除:生活护理模式的替代方案。尽管对在长期护理系统中实施住家护理有不同的看法,但人们一致认为,政治措施必须超越纯粹的法律解决办法。对框架条件、调解和护理实践进行监管是必要的。讨论和结论:对于未来的住家护理设计,特别强调调整财政激励,专业化的住家和住家服务,以及组织和促进非正式护理网络以及与门诊服务等正式提供者的合作作为关键杠杆。在更广泛地讨论对住家照料的管理时,应澄清如何适用有质量保证的长期照料的要求,同时考虑到照料安排的需要。
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来源期刊
CiteScore
1.90
自引率
18.20%
发文量
129
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