TY - JOUR
T1 - Getting to grips with the process of decision-making in long-term care. Descriptive cases illustrate the chaotic reality of the construction of preferences
AU - van Leersum, Catharina M.
AU - Moser, Albine
AU - van Steenkiste, Ben
AU - Wolf, Judith R. L. M.
AU - van der Weijden, Trudy
N1 - Funding Information:
TvdW received a fund by ZonMw, The Hague, The Netherlands (516012502). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors thank all participants and the caregivers for their contribution to this research. The authors also thank Renee de Vet (RdV), Tessa van Loenen (TvL), Marjan Faber (MF), and Miriam Harmsen (MH), employees of Radboud University Medical Center, IQ Healthcare, Impuls, Nijmegen, The Netherlands for their contribution to the data collection.
Publisher Copyright:
© 2019 van Leersum et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2019/5/24
Y1 - 2019/5/24
N2 - BackgroundClients facing decision-making for long-term care are in need of support and accessible information. Construction of preferences, including context and calculations, for clients in long-term care is challenging because of the variability in supply and demand. This study considers clients in four different sectors of long-term care: the nursing and care of the elderly, mental health care, care of people with disabilities, and social care. The aim is to understand the construction of preferences in real-life situations.MethodClient choices were investigated by qualitative descriptive research. Data were collected from 16 in-depth interviews and 79 client records. Interviews were conducted with clients and relatives or informal caregivers from different care sectors. The original client records were explored, containing texts, letters, and comments of clients and caregivers. All data were analyzed using thematic analysis.ResultsFour cases showed how preferences were constructed during the decision-making process. Clients discussed a wide range of challenging aspects that have an impact on the construction of preferences, e.g. previous experiences, current treatment or family situation. This study describes two main characteristics of the construction of preferences: context and calculation.ConclusionClients face diverse challenges during the decision-making process on long-term care and their construction of preferences is variable. A well-designed tool to support the elicitation of preferences seems beneficial.
AB - BackgroundClients facing decision-making for long-term care are in need of support and accessible information. Construction of preferences, including context and calculations, for clients in long-term care is challenging because of the variability in supply and demand. This study considers clients in four different sectors of long-term care: the nursing and care of the elderly, mental health care, care of people with disabilities, and social care. The aim is to understand the construction of preferences in real-life situations.MethodClient choices were investigated by qualitative descriptive research. Data were collected from 16 in-depth interviews and 79 client records. Interviews were conducted with clients and relatives or informal caregivers from different care sectors. The original client records were explored, containing texts, letters, and comments of clients and caregivers. All data were analyzed using thematic analysis.ResultsFour cases showed how preferences were constructed during the decision-making process. Clients discussed a wide range of challenging aspects that have an impact on the construction of preferences, e.g. previous experiences, current treatment or family situation. This study describes two main characteristics of the construction of preferences: context and calculation.ConclusionClients face diverse challenges during the decision-making process on long-term care and their construction of preferences is variable. A well-designed tool to support the elicitation of preferences seems beneficial.
KW - MENTAL-CAPACITY
KW - LIFE
U2 - 10.1371/journal.pone.0217338
DO - 10.1371/journal.pone.0217338
M3 - Article
C2 - 31125374
SN - 1932-6203
VL - 14
JO - PLOS ONE
JF - PLOS ONE
IS - 5
M1 - 0217338
ER -