Wellbeing of lone working Healthcare Assistants (HCAs) delivering palliative care in the community and its impact on staff retention.
Palliative care, mixed-methods research, healthcare assistant, home care services, wellbeing, workforce
Health Care Assistants (HCAs) have an important role caring for patients dying at home and supporting their family caregivers. HCAs often visit patients’ homes on their own, most frequently during the out of hours period. The complexity of this role, combined with how experienced and well-prepared for the role HCAs are, was reported to have an impact on their wellbeing. Staff turnover is high, which is difficult for the organisation managing care in the community and may impact the capacity of services to deliver high quality person-centred care to patients and families.
It is important to understand the level of self-reported wellbeing of lone workers and if they have an intention to leave the job. To gain this knowledge we designed a mixed-method sequential explanatory online study.
Phase 1: An online survey of community lone worker HCAs employed in UK organisations to scope the psychological wellbeing among this group and to assess and compare the psychological wellbeing and intention to leave among lone working HCAs in relation to their employment and demographic characteristics (e.g., gender, age, marital status, education level, care experience etc.).
Phase 2: Online interviews with 6-12 of the community lone worker HCAs who completed the Phase 1 survey, to collect in-depth qualitative data around the same issues.
Quantitative data will be transferred to a statistical software package (SPSS), cleaned and analysed using descriptive and inferential statistics. Free text answers will be analysed using thematic analysis. Interview data will be transcribed verbatim and analysed using thematic analysis.
This research will provide a profile of the level of wellbeing of lone working HCAs in the UK and help their employing organisations understand the current situation regarding their intention to leave and the possible causes. The research team hope it will help to uncover approaches and actions that may be useful for retaining community lone workers and provide evidence for developing interventions and enhancing appropriate support and wellbeing strategies.
A research advisory group has been established to assist in guiding the researchers throughout the research process. Members include current community HCAs, a nurse who previously worked as a HCA, a member of the public, and managers.
A member of the public and a nurse supporting a previous project (‘Lone working practices, support, and educational needs of Healthcare Assistants providing 24/7 palliative care in the community across the UK’) agreed to remain involved via the research advisory group. They have been involved in the early discussion shaping the research question and reviewed this research proposal. Further members joined the research advisory group after the funding application was submitted and have played an active role in developing the survey questions and interview guide, data analysis and dissemination activities.
Survey: May-June 2023
Survey data analysis: June-July 2023
Interviews: July-August 2023
Full data analysis: September-October 2023
Outputs for dissemination expected from October 2023
Ms Katarzyna A. Patynowska, Research Nurse, Marie Curie
Ms Raquel Fantoni, Research Manager, Marie Curie
Dr Felicity Hasson, Senior Lecturer, Ulster University
Dr Tracey McConnell, Senior Research Fellow, Marie Curie
Mr Peter Donnelly, Voices4Care, All Ireland Institute of Hospice and Palliative Care
Ms Colette McAtamney, Registered Nurse, previously Healthcare Assistant, Marie Curie
Mr Jonathan Clemo, Associate Director Strategic Partnerships & Services, Marie Curie
Ms Epiphany Leone, Wellbeing Lead, Marie Curie
Gill Walpole, Healthcare Assistant, Marie Curie
Natasha Wynne, Senior Policy Manager, Marie Curie
The project is funded by Marie Curie Small Research Grants Scheme 2022
Grant Reference: MCSGS-22-801
Patynowska KA, McConnell T, McAtamney C, Hasson F. ‘That just doesn’t feel right at times’–lone working practices, support and educational needs of newly employed Healthcare Assistants providing 24/7 palliative care in the community: A qualitative interview study. Palliative Medicine. 2023 Jun 19:02692163231175990.
Fee A, Hasson F, Slater P, Payne S, McConnell T, Finlay DA, McIlfatrick S. Out-of-hours community palliative care: a national survey of hospice providers. International Journal of Palliative Nursing. 2023 Mar 2;29(3):137-43.
Fee A, Muldrew D, Slater P, Payne S, McIlfatrick S, McConnell T, Finlay DA, Hasson F. The roles, responsibilities and practices of healthcare assistants in out-of-hours community palliative care: A systematic scoping review. Palliative medicine. 2020 Sep;34(8):976-88.
Kasia.Patynowska@mariecurie.org.uk
+447514929000
Twitter handle @KPatynowska
