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Exploring Family-Centered Care from the Perspectives of Home-Health Physical Therapists

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Exploring Family-Centered Care from the Perspectives of Home-Health Physical Therapists Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2020 Exploring Family-Centered Care from the Perspectives of Home- Health Physical Therapists James Mathews Walden University Follow this and additional works at: https://scholarworks.waldenu.edu/dissertations Part of the Health and Medical Administration Commons, and the Physical Therapy Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please contact [email protected]. Walden University College of Health Sciences This is to certify that the doctoral dissertation by James Mathews has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Cheryl Anderson, Committee Chairperson, Health Services Faculty Dr. Josh Bass, Committee Member, Health Services Faculty Dr. Christopher Miller, University Reviewer, Health Services Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2020 Abstract Exploring Family-Centered Care from the Perspectives of Home-Health Physical Therapists by James Mathews DPT, AT, Still University, 2011 MBA, San Diego State University, 2006 BSPT, University of Wisconsin – Madison, 1998 BS, University of Wisconsin – Madison, 1996 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Health Services Walden University November 2020 Abstract Older adults may need, or desire, caregiver and family involvement to avoid hospitalizations and institutionalizations. The caregivers of these older adults have the highest rates of burnout, injury, and turnover. Family-centered care (FCC) involves collaboration between healthcare practitioners, patients, family members, and caregivers. FCC is both established and effective in pediatric care settings. There is a paucity of evidence on how FCC is applied to older adult populations. Home health physical therapists (HHPTs) work with older adults in their homes and train both family members on how to safely handle and manage the care-dependent older adult. The purpose of this single-case study was to explore the perspectives of HHPTs on the delivery of FCC to older adults using a purposeful sample of 14 HHPTs in a community in the western United States. Semi-structured interviews were used to interview each HHPTs. The interview responses were member checked for accuracy and analyzed on a coding table. Three main themes emerged with supporting subthemes. The first theme was that FCC is complex and practiced differently between HHPTs. The second theme was that FCC is used to impact the health factors defined by the International Classification of Functioning, Disability, and Health (ICF) model. The third theme was that contextual factors have the biggest impact on the delivery of FCC. The themes, and supporting subthemes, were conceptualized within the ICF model. Recommendations were made for additional FCC visits, expanded FCC education and training, and further FCC research. This study has the potential to lead to positive social changes through expansions in FCC education, training, and research; improved caregiver, family, and patient health outcomes; and higher patient, family, and caregiver satisfaction. Exploring Family-Centered Care from the Perspectives of Home-Health Physical Therapists by James Mathews DPT, AT Still University, 2011 MBA, San Diego State University, 2006 BSPT, University of Wisconsin – Madison, 1998 BS, University of Wisconsin – Madison, 1996 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Health Services Walden University November 2020 Dedication I would like to dedicate this dissertation to my wife, Nili Mathews, who stood by me on this journey to becoming a Doctor of Philosophy. You helped me to raise two amazing boys, work fulltime, volunteer in the community, advocate for the profession of physical therapy, and thrive in a pandemic. Your faith and love gave me the strength and perseverance I needed. Wherever this journey takes us next, I am here for you too. Forever in your debt, ani l’dodi v’dodi li. Acknowledgments I would like to acknowledge my family and friends. Thank you, father, Dr. James John Mathews, IV, MD, for fostering in me critical thinking skills, authenticity, and generosity. Thank you, mother, Adele Maxine Banner, MA, for teaching me how to be self-reliant, passionate, and tenacious. To all my family and friends, thank you too. Especially my sons, Ben and Zach, stepparents, Ron and Deborah, and mother-in-law, Shelley, who all put up with me talking about older adults, home health, and this dissertation—ad nauseam. I would also like to thank all the current and former members of Title 19 for allowing me in as a novice bass player and expecting me to learn over 100 songs—good times, these…are…the…good times. Next, I would like to acknowledge my dissertation committee. Dr. Cheryl Anderson, PT, PhD, MBA, for mentoring me every step of the way. Dr. Cheryl, as she prefers to be called, was always available for a chat, and helped me immensely. I would also like to thank Dr. Josh Bass, EdD, MS, for being my Committee Member and providing me quality, actionable feedback on my methods and research design. Last, I would like to thank my colleagues and work friends. Thank you, Dr. Ellen Lowe, PT, PhD, MS, who visited me in the Clinical Education department in early 2016 and said, “you know Jim, you should consider getting your PhD”. I would also like to thank Dr. Chris Childers, PT, PhD, MS, Dr. Cherie Peters-Brinkerhoff, PT, EdD, MHA, Dr. Norman Belleza, PT, DPT, Dr. Maureen “Mo” Johnson, OT/L, PhD, MS, Dr. Jennie DiGrado, OTR/L, OTD, Dr. Nicole Rodriguez, PT, DPT and Dr. Kristen Johnson, PT, EdD, MS, for sharing with me your expert opinions, knowledge on being a Doctorate student, and lending a listening ear. Table of Contents List of Tables .......................................................................................................................v List of Figures .................................................................................................................... vi Chapter 1: Introduction to the Study ....................................................................................1 Background ....................................................................................................................5 Problem Statement .........................................................................................................9 Purpose of the Study ....................................................................................................10 Research Question .......................................................................................................10 Conceptual Framework ................................................................................................10 Nature of the Study ......................................................................................................11 Definitions of Terms ....................................................................................................13 Assumptions .................................................................................................................14 Scope and Delimitations ..............................................................................................14 Limitations ...................................................................................................................15 Significance of the Study .............................................................................................16 Summary and Transition ..............................................................................................17 Chapter 2: Literature Review .............................................................................................19 Literature Search Strategy............................................................................................19 Historical Context of FCC ...........................................................................................22 Conceptual Framework ................................................................................................28 Need and Desire for FCC .............................................................................................30 FCC and Aging in Place ....................................................................................... 31 i Culturally Competent Care ................................................................................... 40 Summary of Need and Desire for FCC ................................................................. 45 Case Study Design and Methods .................................................................................45 Similar Single-Case Study Designs ...................................................................... 46 Other Single-Case Study Designs and Methods ................................................... 47 Summary and Conclusions ..........................................................................................50 Chapter 3: Research Method ..............................................................................................51
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