title: [Ambulatory turning point and family home care: a gamble in public health].
abstract: BACKGROUND
  Family caregivers are now considered an at-risk population in Canada. As hospital stays have been gradually reduced, family caregivers of the elderly are burdened with complex responsibilities. This change in care delivery was implemented with little consideration for services offered to this specific population.
  The purpose of this study was to explore the perceptions of four groups of stakeholders towards services as determinants of health: family caregivers, professionals, community organizations and health care administrators. Focus groups (FG) were conducted (n=11 with 49 participants), followed by semi-structured interviews with key informants (n=29), in urban and rural areas. Results of content analysis were categorized according to the Donabedian model. Congruent perceptions between groups pinpointed the following: A limited accessibility of services, a lack of flexibility and coordination of services, a disregard for health promotion of caregivers and a lack of preventive services. Transportation problems and geographical distance to access services were specific to rural area.
  
  
  CONCLUSIONS
  Results provide evidence-based data for public health. They suggest insights for the development of preventive interventions and services for this increasing at-risk population of family caregivers in Canada.
authors.affiliation: Faculté des sciences infirmières, Université de Montréal, et Centre de recherche, Institut universitaire de gériatrie de Montréal, Québec. Francine.Ducharme@umontreal.ca
authors.forename: Francine
authors.initials: F
authors.lastname: Ducharme
authors.forename: Guilhème
authors.initials: G
authors.lastname: Pérodeau
authors.forename: Mario
authors.initials: M
authors.lastname: Paquet
authors.forename: Alain
authors.initials: A
authors.lastname: Legault
authors.forename: Denise
authors.initials: D
authors.lastname: Trudeau
mesh_terms: D000328:Adult; D000368:Aged; D002170:Canada; D017028:Caregivers / Q000523:psychology*; D005190:Family / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011634:Public Health