CHE
CHE
What is CHE Model?
The active involvement of caregivers (Caregiver Engagement) in the process of patient care is an effective response – from a scientific point of view – to the challenges of the current context and the need to create an equitable and sustainable healthcare system. The Caregiver Health Engagement Model configures a multidimensional experience that contributes to determine the involvement of the caregiver in the patient’s care pathway. The dimensions focused on are the following:
• TO EMOTIONALLY PROCESS THE CHANGE
• TO DEVELOP A PROACTIVE AND BALANCED ROLE IN THE CARE PATHWAY
• TO RELATE EFFECTIVELY TO HEALTH PROFESSIONALS AND THE HEALTH CARE SYSTEM
• TO MANAGE THE CARE AND ASSISTANCE NEEDS OF YOUR LOVED ONE
Based on these dimensions, the research identified 4 incremental levels of caregiver involvement expressed in the following profiles:
Denial and Escape
Caregivers are in a situation of emotional shock, overwhelmed by negative emotions, they tend to put in place defensive mechanisms (avoidance, denial, anger), has difficulty understanding and anticipating the care needs of their loved one. They tend to distance themselves from the role of caregiver and delegate every decision to others.
Hyperactivation
Although caregivers have an initial understanding and acceptance of the current state of their loved one, they report a state of emotional alarm and hyperactivity, is careful to monitor every sign and clinical symptom, but they have difficulty in empathizing with the patient’s psychological difficulties. They still prefer to rely on the referring clinicians for clinical decisions.
Abnegation and drowning
Caregivers have been able to develop adaptive strategies for an efficient management of care activities, is more organized, able to read the care needs of their loved one and to respond effectively to them. They have greater legitimacy in actively participating in the conversation with caregivers, but they are still insecure and psychologically fatigued and unable to integrate in a balanced way the role of caregiver with their own needs of life and self-expression.
Balance and equilibrium
Caregiver show full autonomy in responding to the essential needs of their own loved one. They perceive themselves as more capable, effective and confident in their own competences, has managed to consolidate a good partnership relationship with the care team
in which they participate with greater proactivity and collaboration. They have succeeded in finding a greater balance and a more attuned integration of the different life tasks and roles they are called upon to perform.
CHE scale
Starting with the CHE Model, the EngageMinds HUB Centre has generated a scientifically validated Caregiver Engagement assessment and measurement tool.
The CHE Scale diagnoses the caregiver’s level of Engagement and in particular allows for:
• deepening the emotional experience of the caregiver with respect to the changed health conditions of his/her loved one
• understanding how well they are able to reflect the care needs of their loved one and proactively assume a collaborative role with the health care system.
Measuring the level of active involvement of the caregiver – especially in the case of caregivers of high intensity patients – is crucial in order to:
1
Identify the targets most at risk and in need of the most support
2
Provide support and information tailored to the needs of caregivers
Estimate the quality and quantity of interventions to encourage increased levels of engagement
4
Assess the quality and effectiveness of evidence-based interventions