The home care workforce provides supportive healthcare services to older adults. The COVID-19 pandemic heightened the need for knowledge that can better support this high-risk and understudied group of essential workers. The study aimed to understand decision-making about safety and well-being during the COVID-19 pandemic. The study design used a descriptive qualitative study approach, and 34 participants completed individual video or phone interviews. The results were organized into three themes specific to decision-making around safety and well-being for home care workers (HCWs) during the pandemic: 1) Responsibility, commitment, and dedication to their clients led HCWs to continue to provide essential services, 2) Safety concerns did not prevent HCWs from reporting to work, and 3) HCWs expressed more concern about clients than their own safety. Understanding the experiences of HCWs can offer important insights for developing strategies and policies to address the safety of these essential yet often overlooked healthcare professionals.
ArlinghausA.Caban-MartinezA. J.MarinoM.RemeS. E. (2013). The role of ergonomic and psychosocial workplace factors in the reporting of back injuries among U.S. home health aides. American Journal of Industrial Medicine, 56(10), 1239â1244. https://doi.org/10.1002/ajim.22197
AtkinsL.FrancisJ.IslamR.OâConnorD.PateyA.IversN.FoyR.DuncanE. M.ColquhounH.GrimshawJ. M.LawtonR.MichieS. (2017). A guide to using the Theoretical Domains Framework of behaviour change to investigate implementation problems. Implementation Science, 12(1), 77. https://doi.org/10.1186/s13012-017-0605-9
4.
BandiniJ.RollisonJ.FeistelK.WhitakerL.BialasA.EtchegarayJ. (2021). Home care aide safety concerns and job challenges during the COVID-19 pandemic. New Solutions: A Journal of Environmental and Occupational Health Policy, 31(1), 20â29. https://doi.org/10.1177/1048291120987845
5.
BellS. A.KrienkeL. K.DickeyS.De VriesR. G. (2021). âHelping fill that gap:â a qualitative study of aging in place after disaster through the lens of home-based care providers. BMC Geriatrics, 21(1), 235. https://doi.org/10.1186/s12877-021-02159-0
ErlingssonC.BrysiewiczP. (2017). A hands-on guide to doing content analysis. African Journal of Emergency Medicine, 7(3), 93â99. https://doi.org/10.1016/j.afjem.2017.08.001
9.
Forum on Aging, Disability, and Independence, Board on Health Sciences Policy, Division on Behavioral and Social Sciences and Education, Institute of Medicine. (2015). The future of home health care: Workshop summary. National Academies Press (US). & National Research Council.
10.
GebhardD.NeumannJ.WimmerM.MessF. (2022). The Second Side of the Coin-Resilience, Meaningfulness and Joyful Moments in home health care workers during the COVID-19 pandemic. International Journal of Environmental Research and Public Health, 19(7), 3836. https://doi.org/10.3390/ijerph19073836
11.
GrasmoS. G.LiasetI. F.RedzovicS. E. (2021). Home care workersâ experiences of work conditions related to their occupational health: A qualitative study. BMC Health Services Research, 21(1), 962. https://doi.org/10.1186/s12913-021-06941-z
12.
Gray RendĂłnA. (2022). A Case for federal Labor legislation to protect underpaid home care workers. AMA Journal of Ethics, 24(9), E860âE866. https://doi.org/10.1001/amajethics.2022.860
LeeJ.ParasharV.MillerJ.BremmerS.VuJ.WaljeeJ.DossettL. (2018). Opioid prescribing after curative-intent surgery: A qualitative study using the theoretical domains framework. Annals of Surgical Oncology, 25(7), 1843â1851. https://doi.org/10.1245/s10434-018-6466-x
16.
LeeS.OngA. (2020). In AtkinsonP.DelamontS.CernatA.SakshaugJ. W.WilliamsR. A. (Eds.), Respondent-driven sampling. Sage Research Methods Foundations. https://doi.org/10.4135/9781526421036883648
17.
MarkkanenP.BrouilletteN.QuinnM.GalliganC.SamaS.LindbergJ.KarlssonN. (2021). âIt changed everythingâ: The safe home care qualitative study of the COVID-19 pandemicâs impact on home care aides, clients, and managers. BMC Health Services Research, 21(1), 1055. https://doi.org/10.1186/s12913-021-07076-x
18.
McCaugheyD.McGhanG.KimJ.BrannonD.LeroyH.JablonskiR. (2012). Workforce implications of injury among home health workers: Evidence from the national home health aide survey. The Gerontologist, 52(4), 493â505. https://doi.org/10.1093/geront/gnr133
19.
Occupational Safety and Health Administration. (nd). Home healthcare- Overview. Retrieved January 8, 2024, from: https://www.osha.gov/home-healthcare/
PhillipsC. J.MarshallA. P.ChavesN. J.JankelowitzS. K.LinI. B.LoyC. T.ReesG.SakzewskiL.ThomasS.ToT.-P.WilkinsonS. A.MichieS. (2015). Experiences of using the Theoretical domains framework across diverse clinical environments: A qualitative study. Journal of Multidisciplinary Healthcare, 8(1), 139â146. https://doi.org/10.2147/JMDH.S78458
23.
PintoS.MaC.WigginsF.EckerS.ObodaiM.SterlingM. (2022). Forgotten Front line: Understanding the needs of Unionized home health aides in Downstate New York during the COVID-19 pandemic. New Solutions: A Journal of Environmental and Occupational Health Policy, 31(4), 460â468. https://doi.org/10.1177/10482911211058839
24.
SaundersB.SimJ.KingstoneT.BakerS.WaterfieldJ.BartlamB.BurroughsH.JinksC. (2018). Saturation in qualitative research: Exploring its conceptualization and operationalization. Quality and Quantity, 52(4), 1893â1907. https://doi.org/10.1007/s11135-017-0574-8
25.
SterlingM. R.LiJ.ChoJ.RingelJ. B.SilverS. R. (2021). Prevalence and Predictors of home health care workersâ general, Physical, and mental health: Findings from the 2014â2018 behavioral risk factor Surveillance System. American Journal of Public Health, 111(12), 2239â2250. https://doi.org/10.2105/AJPH.2021.306512
26.
SterlingM. R.TsengE.PoonA.ChoJ.AvgarA. C.KernL. M.AnkudaC. K.DellN. (2020). Experiences of home health care workers in New York city during the Coronavirus disease 2019 pandemic: A qualitative analysis. JAMA Internal Medicine, 180(11), 1453â1459. https://doi.org/10.1001/jamainternmed.2020.3930
27.
TavoryI.TimmermansS. (2014). Abductive analysis: Theorizing qualitative research. University of Chicago Press.
28.
TongA.SainsburyP.CraigJ. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care: Journal of the International Society for Quality in Health Care, 19(6), 349â357. https://doi.org/10.1093/intqhc/mzm042
ZoecklerJ. M. (2018). Occupational stress among home healthcare workers: Integrating worker and Agency-level factors. New Solutions: A Journal of Environmental and Occupational Health Policy: NS, 27(4), 524â542. https://doi.org/10.1177/1048291117742678
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
