title: Home support workers perceptions of family members of their older clients: a qualitative study.
abstract: BACKGROUND
  Health care discourse is replete with references to building partnerships between formal and informal care systems of support, particularly in community and home based health care. Little work has been done to examine the relationship between home health care workers and family caregivers of older clients. The purpose of this study is to examine home support workers' (HSWs) perceptions of their interactions with their clients' family members. The goal of this research is to improve client care and better connect formal and informal care systems.
  
  
  METHODS
  A qualitative study, using in-depth interviews was conducted with 118 home support workers in British Columbia, Canada. Framework analysis was used and a number of strategies were employed to ensure rigor including: memo writing and analysis meetings. Interviews were transcribed verbatim and sent to a professional transcription agency. Nvivo 10 software was used to manage the data.
  
  
  RESULTS
  Interactions between HSWs and family members are characterized in terms both of complementary labour (family members providing informational and instrumental support to HSWs), and disrupted labour (family members creating emotion work and additional instrumental work for HSWs). Two factors, the care plan and empathic awareness, further impact the relationship between HSWs and family caregivers.
  
  
  CONCLUSIONS
  HSWs and family members work to support one another instrumentally and emotionally through interdependent interactions and empathic awareness. Organizational Care Plans that are too rigid or limited in their scope are key factors constraining interactions.
authors.affiliation: Department of Family Practice, Centre for Hip Health and Mobility, University of British Columbia, 2635 Laurel St, Vancouver, BC, V5Z 1M9, Canada. joanie.sims-gould@hiphealth.ca.
authors.forename: Joanie
authors.initials: J
authors.lastname: Sims-Gould
authors.affiliation: University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada. kbyrne@uwaterloo.ca.
authors.forename: Kerry
authors.initials: K
authors.lastname: Byrne
authors.affiliation: Centre for Hip Health and Mobility, University of British Columbia, 2635 Laurel St, Vancouver, BC, V5Z 1M9, Canada. catherine.tong@hiphealth.ca.
authors.forename: Catherine
authors.initials: C
authors.lastname: Tong
authors.affiliation: Department of Sociology, University of British Columbia, 6303 N.W. Marine Drive, Vancouver, BC, V6T 1Z1, Canada. amm@exchange.ubc.ca.
authors.forename: Anne
authors.initials: A
authors.lastname: Martin-Matthews
mesh_terms: D000328:Adult; D000368:Aged; D001955:British Columbia; D017028:Caregivers; D005190:Family; D005260:Female; D006699:Home Care Services / Q000458:organization & administration*; D018576:Home Health Aides / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D005791:Patient Care / Q000379:methods*; D010465:Perception; D036301:Qualitative Research