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Hvenær er heimilið besti kosturinn? : áherslur í uppbyggingu heimahjúkrunar

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Authors
Kristín Björnsdóttir
Issue Date
2008-08-01

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Other Titles
When is the home the best choice? Issues and emphases in home care nursing
Citation
Tímarit hjúkrunarfræðinga 2008, 84(3):50-6
Abstract
This paper tries to answer the question: When is the home a good place to provide health care services? To answer this question an extensive literature search was conducted focusing on the home as a place of health care, the organization of health and social services and the participation of relatives in care giving. In addition to the Icelandic and international studies used, the paper was also based on unpublished findings from a study designed and conducted in Reykjavik by the author. The main findings show that people’s relationship to their homes is complex and sometimes contradictory, laden with an array of different feelings and understandings, which nurses need to know how to respond to. Similarly, the studies reviewed show that the views of relatives towards their roles and responsiblities are ambiguous. Most of them express a need for more assistance form the authorities than they receive. Many countries have developed community based services aimed at supporting people to live at home in spite of debilitating long term conditions. However, studies show that theses services suffer from rationing. Therefore, the final part of the paper attempts to clarify the complex ethical and political issues with which home care nurses are confronted in their practice.
Í þessari grein er leitað svara við spurningunni: Hvenær er heimilið ákjósanlegur staður til að veita heilbrigðisþjónustu? Til að svara henni var gerð ítarleg leit að efni um aðstæður á heimilum, skipulag heilbrigðis- og stuðningsþjónustu á heimilum og um þátttöku aðstandenda í umönnun á heimilum. Auk þeirra íslensku og alþjóðlegu rannsókna, sem stuðst var við, byggir umfjöllunin einnig á óbirtum niðurstöðum rannsókna höfundar á heimahjúkrun á höfuðborgarsvæðinu sem nefnist Hjúkrað heima. Fram kemur að samband fólks við heimili sín er í mörgum tilvikum flókið og tvíbent, hlaðið ólíkum tilfinningum og skilningi sem mikilvægt er að hjúkrunarfræðingar þekki og geti brugðist við. Á svipaðan hátt er afstaða aðstandenda til aðstæðna sinna margræð en flestir þeirra óska eftir meiri stuðningi frá hinu opinbera en þeim er veittur. Víða í heiminum hefur verið byggð upp umfangsmikil heimaþjónusta sem miðar að því að styðja fólk til að búa áfram heima. Rannsóknir sýna þó að oft er slíkri þjónustu sniðinn ansi þröngur fjárhagslegur rammi. Því er leitast við að varpa ljósi á hin flóknu siðfræðilegu og pólitísku álitamál sem hjúkrunarfræðingar í heimahjúkrun standa frammi fyrir í kjölfar þess að heimilið verður vettvangur heilbrigðisþjónustu.
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