Marchand Lucille, Fowler Kathryn J, Kokanovic Obrad
Department of Family Medicine, University of Wisconsin Medical School, Madison, USA.
Am J Hosp Palliat Care. 2006 Mar-Apr;23(2):119-26. doi: 10.1177/104990910602300209.
Advance care planning (ACP) has had few successful initiatives. This qualitative study explores the challenges and successes of an advance care planning coalition in Wisconsin called Life Planning 2000 using key informant interviews (n = 24) and grounded theory. Major themes included: commitment (the need for leadership, recruitment of key members, and funding); cohesiveness (disparate groups collaborating toward a common purpose), and outcomes (shift in paradigm from signing documents to process of advanced care planning, new-found collaborative relationships, and educational tool development). Coalitions need to define short-, intermediate-, and long-term goals that result in measurable outcomes and an evaluation process. Resources must be commensurate with goals. Strong leadership, paid staff adequate funding, and the collaboration of diverse groups working toward common goals are the basic requirements of a successful coalition.
预先护理计划(ACP)鲜有成功的举措。这项定性研究通过关键 informant 访谈(n = 24)和扎根理论,探讨了威斯康星州一个名为“2000 年生命规划”的预先护理计划联盟所面临的挑战与取得的成功。主要主题包括:承诺(对领导力的需求、关键成员的招募以及资金);凝聚力(不同群体为共同目标而协作),以及成果(从签署文件到预先护理计划过程的范式转变、新建立的合作关系以及教育工具的开发)。联盟需要明确能产生可衡量成果的短期、中期和长期目标以及评估过程。资源必须与目标相匹配。强有力的领导、带薪工作人员、充足的资金以及朝着共同目标努力的不同群体之间的合作是成功联盟的基本要求。