Experiences of Home Health Care Workers in New York City During the Coronavirus Disease 2019 Pandemic: A Qualitative Analysis
IMPORTANCE: Home health care workers care for community-dwelling adults and play an important role in supporting patients with confirmed and suspected coronavirus disease 2019 (COVID-19) who remain at home. These workers are mostly middle-aged women and racial/ethnic minorities who typically earn lo...
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Veröffentlicht in: | Archives of internal medicine (1960) 2020-11, Vol.180 (11), p.1453-1459 |
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description | IMPORTANCE: Home health care workers care for community-dwelling adults and play an important role in supporting patients with confirmed and suspected coronavirus disease 2019 (COVID-19) who remain at home. These workers are mostly middle-aged women and racial/ethnic minorities who typically earn low wages. Despite being integral to patient care, these workers are often neglected by the medical community and society at large; thus, developing a health care system capable of addressing the COVID-19 crisis and future pandemics requires a better understanding of the experiences of home health care workers. OBJECTIVE: To understand the experiences of home health care workers caring for patients in New York City during the COVID-19 pandemic. DESIGN, SETTING, AND PARTICIPANTS: From March to April 2020, a qualitative study with 1-to-1 semistructured interviews of 33 home health care workers in New York City was conducted in partnership with the 1199SEIU Home Care Industry Education Fund, a benefit fund of the 1199 Service Employees International Union United Healthcare Workers East, the largest health care union in the US. Purposeful sampling was used to identify and recruit home health care workers. MAIN OUTCOMES AND MEASURES: Audio-recorded interviews were professionally transcribed and analyzed using grounded theory. Major themes and subthemes were identified. RESULTS: In total, 33 home health care workers employed by 24 unique home care agencies across the 5 boroughs of New York City participated. Participants had a mean (SD) age of 47.6 (14.0) years, 32 (97%) were women, 21 (64%) were Black participants, and 6 (18%) were Hispanic participants. Five major themes emerged: home health care workers (1) were on the front lines of the COVID-19 pandemic but felt invisible; (2) reported a heightened risk for virus transmission; (3) received varying amounts of information, supplies, and training from their home care agencies; (4) relied on nonagency alternatives for support, including information and supplies; and (5) were forced to make difficult trade-offs in their work and personal lives. CONCLUSIONS AND RELEVANCE: In this qualitative analysis, home health care workers reported providing frontline essential care, often at personal risk, during the COVID-19 pandemic. They experienced challenges that exacerbated the inequities they face as a marginalized workforce. Interventions and policies to better support these frontline health care professionals are urgently ne |
doi_str_mv | 10.1001/jamainternmed.2020.3930 |
format | Article |
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These workers are mostly middle-aged women and racial/ethnic minorities who typically earn low wages. Despite being integral to patient care, these workers are often neglected by the medical community and society at large; thus, developing a health care system capable of addressing the COVID-19 crisis and future pandemics requires a better understanding of the experiences of home health care workers. OBJECTIVE: To understand the experiences of home health care workers caring for patients in New York City during the COVID-19 pandemic. DESIGN, SETTING, AND PARTICIPANTS: From March to April 2020, a qualitative study with 1-to-1 semistructured interviews of 33 home health care workers in New York City was conducted in partnership with the 1199SEIU Home Care Industry Education Fund, a benefit fund of the 1199 Service Employees International Union United Healthcare Workers East, the largest health care union in the US. Purposeful sampling was used to identify and recruit home health care workers. MAIN OUTCOMES AND MEASURES: Audio-recorded interviews were professionally transcribed and analyzed using grounded theory. Major themes and subthemes were identified. RESULTS: In total, 33 home health care workers employed by 24 unique home care agencies across the 5 boroughs of New York City participated. Participants had a mean (SD) age of 47.6 (14.0) years, 32 (97%) were women, 21 (64%) were Black participants, and 6 (18%) were Hispanic participants. Five major themes emerged: home health care workers (1) were on the front lines of the COVID-19 pandemic but felt invisible; (2) reported a heightened risk for virus transmission; (3) received varying amounts of information, supplies, and training from their home care agencies; (4) relied on nonagency alternatives for support, including information and supplies; and (5) were forced to make difficult trade-offs in their work and personal lives. CONCLUSIONS AND RELEVANCE: In this qualitative analysis, home health care workers reported providing frontline essential care, often at personal risk, during the COVID-19 pandemic. They experienced challenges that exacerbated the inequities they face as a marginalized workforce. Interventions and policies to better support these frontline health care professionals are urgently needed.</description><identifier>ISSN: 2168-6106</identifier><identifier>EISSN: 2168-6114</identifier><identifier>DOI: 10.1001/jamainternmed.2020.3930</identifier><identifier>PMID: 32749450</identifier><language>eng</language><publisher>United States: American Medical Association</publisher><subject>COVID-19 ; COVID-19 - epidemiology ; COVID-19 - prevention & control ; COVID-19 - psychology ; Ethnicity ; Female ; Helping Behavior ; Home Care Agencies - organization & administration ; Home Care Services - statistics & numerical data ; Home Care Services - trends ; Home Health Aides - psychology ; Home health care ; Humans ; Independent Living ; Male ; Medical personnel ; Middle Aged ; New York City - epidemiology ; Occupational Stress - etiology ; Occupational Stress - psychology ; Online First ; Original Investigation ; Patients ; Qualitative Research ; SARS-CoV-2 ; Sex Factors ; Social Perception ; Social Support</subject><ispartof>Archives of internal medicine (1960), 2020-11, Vol.180 (11), p.1453-1459</ispartof><rights>Copyright American Medical Association Nov 2020</rights><rights>Copyright 2020 American Medical Association. All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-a361t-271da1c604c829d79f572085e7b9f4a0ed8c6e57eec3f6e1fcd79fdad2525fa33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jamanetwork.com/journals/jamainternalmedicine/articlepdf/10.1001/jamainternmed.2020.3930$$EPDF$$P50$$Gama$$H</linktopdf><linktohtml>$$Uhttps://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2020.3930$$EHTML$$P50$$Gama$$H</linktohtml><link.rule.ids>64,230,314,780,784,885,3340,27924,27925,76489,76492</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32749450$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sterling, Madeline R</creatorcontrib><creatorcontrib>Tseng, Emily</creatorcontrib><creatorcontrib>Poon, Anthony</creatorcontrib><creatorcontrib>Cho, Jacklyn</creatorcontrib><creatorcontrib>Avgar, Ariel C</creatorcontrib><creatorcontrib>Kern, Lisa M</creatorcontrib><creatorcontrib>Ankuda, Claire K</creatorcontrib><creatorcontrib>Dell, Nicola</creatorcontrib><title>Experiences of Home Health Care Workers in New York City During the Coronavirus Disease 2019 Pandemic: A Qualitative Analysis</title><title>Archives of internal medicine (1960)</title><addtitle>JAMA Intern Med</addtitle><description>IMPORTANCE: Home health care workers care for community-dwelling adults and play an important role in supporting patients with confirmed and suspected coronavirus disease 2019 (COVID-19) who remain at home. These workers are mostly middle-aged women and racial/ethnic minorities who typically earn low wages. Despite being integral to patient care, these workers are often neglected by the medical community and society at large; thus, developing a health care system capable of addressing the COVID-19 crisis and future pandemics requires a better understanding of the experiences of home health care workers. OBJECTIVE: To understand the experiences of home health care workers caring for patients in New York City during the COVID-19 pandemic. DESIGN, SETTING, AND PARTICIPANTS: From March to April 2020, a qualitative study with 1-to-1 semistructured interviews of 33 home health care workers in New York City was conducted in partnership with the 1199SEIU Home Care Industry Education Fund, a benefit fund of the 1199 Service Employees International Union United Healthcare Workers East, the largest health care union in the US. Purposeful sampling was used to identify and recruit home health care workers. MAIN OUTCOMES AND MEASURES: Audio-recorded interviews were professionally transcribed and analyzed using grounded theory. Major themes and subthemes were identified. RESULTS: In total, 33 home health care workers employed by 24 unique home care agencies across the 5 boroughs of New York City participated. Participants had a mean (SD) age of 47.6 (14.0) years, 32 (97%) were women, 21 (64%) were Black participants, and 6 (18%) were Hispanic participants. Five major themes emerged: home health care workers (1) were on the front lines of the COVID-19 pandemic but felt invisible; (2) reported a heightened risk for virus transmission; (3) received varying amounts of information, supplies, and training from their home care agencies; (4) relied on nonagency alternatives for support, including information and supplies; and (5) were forced to make difficult trade-offs in their work and personal lives. CONCLUSIONS AND RELEVANCE: In this qualitative analysis, home health care workers reported providing frontline essential care, often at personal risk, during the COVID-19 pandemic. They experienced challenges that exacerbated the inequities they face as a marginalized workforce. Interventions and policies to better support these frontline health care professionals are urgently needed.</description><subject>COVID-19</subject><subject>COVID-19 - epidemiology</subject><subject>COVID-19 - prevention & control</subject><subject>COVID-19 - psychology</subject><subject>Ethnicity</subject><subject>Female</subject><subject>Helping Behavior</subject><subject>Home Care Agencies - organization & administration</subject><subject>Home Care Services - statistics & numerical data</subject><subject>Home Care Services - trends</subject><subject>Home Health Aides - psychology</subject><subject>Home health care</subject><subject>Humans</subject><subject>Independent Living</subject><subject>Male</subject><subject>Medical personnel</subject><subject>Middle Aged</subject><subject>New York City - epidemiology</subject><subject>Occupational Stress - etiology</subject><subject>Occupational Stress - psychology</subject><subject>Online First</subject><subject>Original Investigation</subject><subject>Patients</subject><subject>Qualitative Research</subject><subject>SARS-CoV-2</subject><subject>Sex Factors</subject><subject>Social Perception</subject><subject>Social Support</subject><issn>2168-6106</issn><issn>2168-6114</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkU1v1DAQhiMEolXpH-AAlrhw2WVsJ3bCAWm1LSxSxYcEQpysaTLpeknsrZ0s7IH_jqMtK4ovtjXPvPL4ybLnHOYcgL_aYI_WDRRcT81cgIC5rCQ8yE4FV-VMcZ4_PJ5BnWTnMW4grRIgl_JxdiKFzqu8gNPs9-WvLQVLrqbIfMtWvie2IuyGNVtiIPbNhx8UIrOOfaCf7Hu6sqUd9uxiDNbdsGFNbOmDd7izYYzswkbCSEwAr9gndA31tn7NFuzziJ0dcLA7YguH3T7a-CR71GIX6fxuP8u-vr38slzNrj6-e79cXM1QKj7MhOYN8lpBXpeianTVFlpAWZC-rtocgZqyVlRoolq2inhbT0yDjShE0aKUZ9mbQ-52vE5_VpMbAnZmG2yPYW88WnO_4uza3Pid0TnkoHgKeHkXEPztSHEwvY01dR068mM0IpcgtS6VSuiL_9CNH0MaeKIUFAnTU6A-UHXwMQZqj4_hYCbL5p5lM1k2k-XU-ezfWY59f50m4OkBSAHHqtCqgkrJP_zXsKI</recordid><startdate>20201101</startdate><enddate>20201101</enddate><creator>Sterling, Madeline R</creator><creator>Tseng, Emily</creator><creator>Poon, Anthony</creator><creator>Cho, Jacklyn</creator><creator>Avgar, Ariel C</creator><creator>Kern, Lisa M</creator><creator>Ankuda, Claire K</creator><creator>Dell, Nicola</creator><general>American Medical Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20201101</creationdate><title>Experiences of Home Health Care Workers in New York City During the Coronavirus Disease 2019 Pandemic: A Qualitative Analysis</title><author>Sterling, Madeline R ; Tseng, Emily ; Poon, Anthony ; Cho, Jacklyn ; Avgar, Ariel C ; Kern, Lisa M ; Ankuda, Claire K ; Dell, Nicola</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a361t-271da1c604c829d79f572085e7b9f4a0ed8c6e57eec3f6e1fcd79fdad2525fa33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>COVID-19</topic><topic>COVID-19 - epidemiology</topic><topic>COVID-19 - prevention & control</topic><topic>COVID-19 - psychology</topic><topic>Ethnicity</topic><topic>Female</topic><topic>Helping Behavior</topic><topic>Home Care Agencies - organization & administration</topic><topic>Home Care Services - statistics & numerical data</topic><topic>Home Care Services - trends</topic><topic>Home Health Aides - psychology</topic><topic>Home health care</topic><topic>Humans</topic><topic>Independent Living</topic><topic>Male</topic><topic>Medical personnel</topic><topic>Middle Aged</topic><topic>New York City - epidemiology</topic><topic>Occupational Stress - etiology</topic><topic>Occupational Stress - psychology</topic><topic>Online First</topic><topic>Original Investigation</topic><topic>Patients</topic><topic>Qualitative Research</topic><topic>SARS-CoV-2</topic><topic>Sex Factors</topic><topic>Social Perception</topic><topic>Social Support</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sterling, Madeline R</creatorcontrib><creatorcontrib>Tseng, Emily</creatorcontrib><creatorcontrib>Poon, Anthony</creatorcontrib><creatorcontrib>Cho, Jacklyn</creatorcontrib><creatorcontrib>Avgar, Ariel C</creatorcontrib><creatorcontrib>Kern, Lisa M</creatorcontrib><creatorcontrib>Ankuda, Claire K</creatorcontrib><creatorcontrib>Dell, Nicola</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Archives of internal medicine (1960)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sterling, Madeline R</au><au>Tseng, Emily</au><au>Poon, Anthony</au><au>Cho, Jacklyn</au><au>Avgar, Ariel C</au><au>Kern, Lisa M</au><au>Ankuda, Claire K</au><au>Dell, Nicola</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Experiences of Home Health Care Workers in New York City During the Coronavirus Disease 2019 Pandemic: A Qualitative Analysis</atitle><jtitle>Archives of internal medicine (1960)</jtitle><addtitle>JAMA Intern Med</addtitle><date>2020-11-01</date><risdate>2020</risdate><volume>180</volume><issue>11</issue><spage>1453</spage><epage>1459</epage><pages>1453-1459</pages><issn>2168-6106</issn><eissn>2168-6114</eissn><abstract>IMPORTANCE: Home health care workers care for community-dwelling adults and play an important role in supporting patients with confirmed and suspected coronavirus disease 2019 (COVID-19) who remain at home. These workers are mostly middle-aged women and racial/ethnic minorities who typically earn low wages. Despite being integral to patient care, these workers are often neglected by the medical community and society at large; thus, developing a health care system capable of addressing the COVID-19 crisis and future pandemics requires a better understanding of the experiences of home health care workers. OBJECTIVE: To understand the experiences of home health care workers caring for patients in New York City during the COVID-19 pandemic. DESIGN, SETTING, AND PARTICIPANTS: From March to April 2020, a qualitative study with 1-to-1 semistructured interviews of 33 home health care workers in New York City was conducted in partnership with the 1199SEIU Home Care Industry Education Fund, a benefit fund of the 1199 Service Employees International Union United Healthcare Workers East, the largest health care union in the US. Purposeful sampling was used to identify and recruit home health care workers. MAIN OUTCOMES AND MEASURES: Audio-recorded interviews were professionally transcribed and analyzed using grounded theory. Major themes and subthemes were identified. RESULTS: In total, 33 home health care workers employed by 24 unique home care agencies across the 5 boroughs of New York City participated. Participants had a mean (SD) age of 47.6 (14.0) years, 32 (97%) were women, 21 (64%) were Black participants, and 6 (18%) were Hispanic participants. Five major themes emerged: home health care workers (1) were on the front lines of the COVID-19 pandemic but felt invisible; (2) reported a heightened risk for virus transmission; (3) received varying amounts of information, supplies, and training from their home care agencies; (4) relied on nonagency alternatives for support, including information and supplies; and (5) were forced to make difficult trade-offs in their work and personal lives. CONCLUSIONS AND RELEVANCE: In this qualitative analysis, home health care workers reported providing frontline essential care, often at personal risk, during the COVID-19 pandemic. They experienced challenges that exacerbated the inequities they face as a marginalized workforce. Interventions and policies to better support these frontline health care professionals are urgently needed.</abstract><cop>United States</cop><pub>American Medical Association</pub><pmid>32749450</pmid><doi>10.1001/jamainternmed.2020.3930</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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subjects | COVID-19 COVID-19 - epidemiology COVID-19 - prevention & control COVID-19 - psychology Ethnicity Female Helping Behavior Home Care Agencies - organization & administration Home Care Services - statistics & numerical data Home Care Services - trends Home Health Aides - psychology Home health care Humans Independent Living Male Medical personnel Middle Aged New York City - epidemiology Occupational Stress - etiology Occupational Stress - psychology Online First Original Investigation Patients Qualitative Research SARS-CoV-2 Sex Factors Social Perception Social Support |
title | Experiences of Home Health Care Workers in New York City During the Coronavirus Disease 2019 Pandemic: A Qualitative Analysis |
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