title: Types and patterns of safety concerns in home care: client and family caregiver perspectives.
abstract: OBJECTIVE
  Drawing on interviews with home care clients and their family caregivers, we sought to understand how these individuals conceptualize safety in the provision and receipt of home care, how they promote safety in the home space and how their safety concerns differ from those of home support workers.
  
  
  METHODS
  In-depth, semi-structured interviews were conducted with clients and family caregivers. The analysis included topic and analytical coding of participants' verbatim accounts.
  
  
  METHODS
  Interviews were completed in British Columbia, Canada.
  
  
  METHODS
  Totally 82 clients and 55 caregivers participated.
  
  
  RESULTS
  Clients and family caregivers identified three types of safety concerns: physical, spatial and interpersonal. These concerns are largely multi-dimensional and intersectional. We present a conceptual model of client and caregiver safety concerns. We also examine the factors that intensify and mitigate safety concerns in the home.
  
  
  CONCLUSIONS
  In spite of safety concerns, clients and family caregivers overwhelmingly prefer to receive care in the home setting. Spatial and physical concerns are the most salient. The financial burden of creating a safe care space should not be the client's alone to bear. The conceptualization and promotion of safety in home care must recognize the roles, responsibilities and perspectives of all of the actors involved, including workers, clients and their caregivers.
authors.affiliation: Centre for Hip Health & Mobility, Vancouver Costal Health Research Institute, University of British Columbia, Vancouver, Canada.
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Tong
authors.affiliation: Centre for Hip Health & Mobility, Vancouver Costal Health Research Institute, University of British Columbia, Vancouver, Canada Faculty of Medicine, University of British Columbia, Vancouver, Canada.
authors.forename: Joanie
authors.initials: J
authors.lastname: Sims-Gould
authors.affiliation: Department of Sociology, University of British Columbia, Vancouver, Canada.
authors.forename: Anne
authors.initials: A
authors.lastname: Martin-Matthews
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology; D005260:Female; D006699:Home Care Services / Q000592:standards; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D061214:Patient Safety
keywords: aged; caregivers; home care services; qualitative research; safety
references.citation: J Occup Health Psychol. 2004 Jul;9(3):206-19
references.pmid: 15279516
references.citation: Appl Ergon. 2004 Jul;35(4):393-9
references.pmid: 15159204
references.citation: J Eval Clin Pract. 2003 May;9(2):187-94
references.pmid: 12787182
references.citation: Int Arch Occup Environ Health. 2003 Apr;76(3):216-24
references.pmid: 12690496
references.citation: Women Health. 2000;31(2-3):1-35
references.pmid: 11289681
references.citation: BMJ. 2000 Jan 8;320(7227):114-6
references.pmid: 10625273
references.citation: Int J Qual Health Care. 2014 Apr;26(2):136-43
references.pmid: 24521705
references.citation: BMJ Qual Saf. 2013 Dec;22(12):989-97
references.pmid: 23828878
references.citation: J Appl Gerontol. 2013 Feb;32(1):31-50
references.pmid: 25473925
references.citation: Can J Aging. 2011 Jun;30(2):233-45
references.pmid: 24650672
references.citation: Int J Qual Health Care. 2013 Feb;25(1):16-28
references.pmid: 23283731
references.citation: Health Soc Care Community. 2012 Nov;20(6):599-606
references.pmid: 22804820
references.citation: Int J Qual Health Care. 2012 Oct;24(5):525-31
references.pmid: 22864107
references.citation: Healthc Q. 2012;15 Spec No:68-72
references.pmid: 22874450
references.citation: Home Health Care Serv Q. 2010 Apr;29(2):55-74
references.pmid: 20635271
references.citation: Int J Qual Health Care. 2010 Apr;22(2):115-25
references.pmid: 20147333
references.citation: Int J Qual Health Care. 2010 Apr;22(2):75-7
references.pmid: 20144941
references.citation: Healthc Q. 2009;12 Spec No Patient:97-101
references.pmid: 19667785
references.citation: Home Health Care Serv Q. 2008;27(2):75-99
references.pmid: 18928206
references.citation: Int J Qual Health Care. 2008 Apr;20(2):130-5
references.pmid: 18158294
references.citation: J Health Serv Res Policy. 2008 Jan;13 Suppl 1:20-4
references.pmid: 18325164
references.citation: Healthc Q. 2006;9 Spec No:127-34
references.pmid: 17087182
references.citation: J Adv Nurs. 2006 Jan;53(1):91-100; discussion 101-3
references.pmid: 16422698
references.citation: Br J Community Nurs. 2005 Jun;10(6):284-91
references.pmid: 15944514