Enabling access to primary care: The experiences of disability support workers

Abstract

As a group, disabled people experience poorer health outcomes than the general population and are disadvantaged in their access to primary care services. Support workers are considered as one resource for improving access to primary care for disabled people and health outcomes of this diverse population. However, there is a dearth of research about the disability support workforce, in particular, research investigating their roles in enabling access to primary care for disabled people. This thesis, therefore, seeks to gain a better understanding of this under-researched area of disability support workers supporting access to primary care by inquiring with the disability support workforce. Using a qualitative methodology with an interpretive approach, 11 support workers based in Auckland, New Zealand were interviewed about their lived experiences of supporting disabled people to primary care. These semi-structured face to face interviews took place over a period of two months in 2017 and were recorded, transcribed verbatim and analysed using inductive thematic analysis. The analysis identifies support workers’ understandings of their role in supporting disabled people to access primary care, and discusses their perceived key enablers and barriers faced when supporting disabled people in this setting. This thesis highlights the support worker’s role as a “facilitator” when supporting disabled people in primary care by helping both patients and general practitioners in communicating and understanding information exchanged. Factors that help facilitate good access to primary care included having respectful doctor-patient interactions and relationships, having doctors and support workers who know the service user, having a strong team approach among support staff and on-the-job peer support, as well as having access to continuous training to keep up with service users’ needs. The key barriers faced by support workers in supporting access to care were difficulty in managing challenging behaviours of service users and gaps in knowledge and training for support workers. This research identifies an important need for specialised training for the disability support workforce and additional research about their important role as facilitators in service users’ access to good quality health care.