A meta-synthesis describing the relationships between patients, informal caregivers and health professionals in home-care settings

Aim. The present study describes, through a meta-synthesis, the relationship between patients, informal caregivers and health professionals involved in home care. Background. Today, many people receive help from health care professionals in their homes with the consequence that, for many health care professionals, their working place is the patients' homes. Research that addresses the dynamics in the caring relationship in home care seems to be rare. Design. A meta-synthesis is an integrated interpretation of qualitative research findings, which is more substantive than the results from each individual investigation. Method. We performed a systematic literature search regarding studies published during the period 1992-2005, using the search terms home nursing, professional and home health care. The included studies described relations in a home care context, between health professionals and patients or relations between health professionals, patients and their informal caregivers published in the same study. Results. The findings showed that when professionals entered people's home, the private area changed. The study presents an interpretation of the changed meanings of home as the place and space for professional care. We described the meanings of the relationship in two main themes with subthemes. The main themes are 'being there' and 'home care as a co-creation'. The understanding of relationships in home care is seen as the development of a professional friendship. This concept is reflected on through the writings of Aristotle and Alberoni. Conclusion. To address these concerns, it is important that home care providers, recipients and their family members develop friendships. These friendships should be a part of any professional relationship. Relevance to clinical practice. When health professionals enter patients' homes, they have to be aware of the risk of transgressing borders of privacy. In addition, devaluing patients' or their informal caregivers' knowledge and their opinions about the care is interpreted as an exercise of institutional power.