title: An evaluation of the effectiveness of engaging Canadian clients as partners in in-home care.
abstract: This exploratory quasi-experimental evaluation assessed the effectiveness of the use of a concrete discussion guide to promote organisation-wide application of a partnering approach to engage older home-care clients with chronic disease/disabilities as care partners. A post-test-only design with an independent pre-test sample was used to compare selected outcomes with those of standard in-home care. The theoretically informed discussion guide portrayed how to go about the process of empowering partnering by using language and open-ended conversational leads to construct partnering, partnering effort and health as a resource for everyday living through social interaction. The discussion guide was provided to all providers for use with all clients in one home-care programme in Ontario, Canada and this organisation was compared with a similar but geographically distanced organisation, also in Ontario. Seven hundred and ninety-one randomly selected clients (mean age = 72.5 years) receiving 3+ months of in-home care for chronic conditions/disabilities from the two home-care programmes between September 2007 and May 2010 completed a researcher-administered questionnaire at either baseline, 1 year or 2 years. Instruments included the Client's Partnering Experience, Health-Promoting Partnering Effort, a modified version of Locus of Authority in Decision-Making, the Medical Outcomes Survey Self-Rated Health Scale, Health and Social Services Utilization and a modified Functional Independence Measure. Analysis of covariance revealed that the use of the concrete discussion guide to promote organisation-wide application of a partnering approach achieved significantly greater client partnering experience and health-promoting partnering effort over time than did the usual approach to in-home-care interactions. Using the discussion guide enhanced client/provider partnering, hence, interdependence, contributing positively to promoting clients' health as a resource for everyday living.
authors: The Arthur Labatt Family School of Nursing, Faculty of Health Sciences, Western University, London, ON, Canada.
authors: C L
authors: CL
authors: McWilliam
authors: E
authors: E
authors: Vingilis
authors: C
authors: C
authors: Ward-Griffin
authors: K
authors: K
authors: Higuchi
authors: M
authors: M
authors: Stewart
authors: T
authors: T
authors: Mantler
authors: R
authors: R
authors: Gao
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003299:Cooperative Behavior; D005260:Female; D006701:Home Nursing; D006801:Humans; D008297:Male; D009864:Ontario; D010361:Patients / Q000523:psychology*; D011369:Professional-Patient Relations; D015397:Program Evaluation; D012946:Social Welfare
keywords: chronic care management; community-based care; health promotion; in-home care; interdependence