An extra care community's perceived priorities for 'whole system' relationships: a Q-methodological study

Area of Science:

• Health Services Research
• Social Care
• Organizational Psychology

Background:

• Healthcare and social care systems globally require sustainable improvements in inter-community relationships.
• A relational framework is needed to guide practitioners and enhance 'whole system' approaches.

Purpose of the Study:

• To develop a relational framework for quality relationships based on diverse stakeholder perspectives.
• To identify and organize the core elements of quality relationships.

Main Methods:

• Action research with practitioners and a literature review informed the framework.
• Q methodology and by-person factor analysis were used with 27 stakeholders (staff, residents, families, service providers).
• Participants rank-ordered 48 statements on relationship aspects, with interviews supplementing data.

Main Results:

• Five distinct viewpoints on quality relationships emerged: 'Altogether now' (compassionate engagement), 'Respect is a two-way street' (reciprocity), 'Free spirits' (freedom), 'Families…strengths and challenges' (family involvement), and 'Helping hands' (social integration).
• These viewpoints highlight varied priorities, including compassion, mutual respect, autonomy, family dynamics, and support for isolated residents.

Conclusions:

• Recognizing diverse perspectives on relationship quality is crucial for effective practice in extra care settings.
• The relational framework can help communities leverage relationships as a resource to improve care quality and social integration.