Prerequisites of a Client-centered Approach in Home Care Services for Older People: A Multiple Constituency Evaluation

Päivi Sanerma

Research output: Book/ReportDoctoral thesisCollection of Articles


The background of this study is the concentration of the provision of home care services for older people and the increasing number of home care clients. Living longer at home and continuing an active life of high quality is an important health policy goal for Finland and the European Union. The use of a client-centered approach in home care services has been described as a key goal for the implementation and value base of the services. This study is based on a need to develop evidence-based home care services and care and related evaluation from the perspectives of different stakeholders.

The purpose of this study is to produce a metasynthesis of the prerequisites of a client-centered approach in home care. The goal is to produce nursing science evaluation knowledge about client-centered home care services and prerequisites of the implementation of the services. In addition, the study produces evidence of using different kinds of evaluation methods in the home care context.

The research method of multiconstituency evaluation has been used. The perspectives of the evaluations included the client’s, family members’, home care professionals’ and service managers’ points of view. Stakeholders’ evaluations in the study were implemented by using realistic evaluation (client and family members) and developmental evaluation (home care professionals and service managers). The research data was collected from home care professionals in thematic interviews, in pair interviews, group interviews and in interactive group interviews during the research process. The study results were mirrored in the literature using integrative literature review. This research has used the concept of a client-centered approach (e.g., person-centered) because the study was limited to a perspective in which persons are in a relationship between a client and professional or between family member or work in home care as professionals.

The study resulted in producing evaluations by key stakeholders about the prerequisites of a client-centered approach. Categories were created in a metasynthesis to describe the prerequisites of client-centered approach in home care. The categories of results were client’s and family members’ involvement and participation, comprehensive and multiprofessional case management, evidence-based service delivery, use of a digital home care operating environment, modernized service models and utilization of technology, reform of management, and interactive political decision-making. In addition, the study produced home care assessment criteria and recommendations for client-centered home care services and care.

The results of the study can be utilized in the development of client-centered home care services and operational models, in the evaluation of client-centered approach, and in the development of methodology for evaluation, education and research related to home care.
Original languageEnglish
Place of PublicationTampere
ISBN (Electronic)978-952-03-2594-7
Publication statusPublished - 2022
Publication typeG5 Doctoral dissertation (articles)

Publication series

NameTampere University Dissertations - Tampereen yliopiston väitöskirjat
ISSN (Print)2489-9860
ISSN (Electronic)2490-0028


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