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一项基于社区的新型老年干预项目的可行性:对全科医生、护士、老年病科医生、患者及照护者体验的探索

Feasibility of a new community-based geriatric intervention programme: an exploration of experiences of GPs, nurses, geriatricians, patients and caregivers.

作者信息

van Eijken Monique, Melis René, Wensing Michel, Rikkert Marcel Olde, van Achterberg Theo

机构信息

Centre for Quality of Care Research (WOK), Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.

出版信息

Disabil Rehabil. 2008;30(9):696-708. doi: 10.1080/09638280701400508.

Abstract

PURPOSE

To determine the feasibility of the Dutch Geriatric Intervention Programme (DGIP) in primary care. Within the DGIP, a nurse cooperates with a General Practitioner (GP) and a clinical geriatrician to assess and manage care for community-living older patients. The aim of this study was to describe both views of care receivers and those of professionals in order to identify facilitating factors and barriers for implementation of the DGIP.

METHOD

Combined quantitative and qualitative data collection methods were used. Pre- and post-questionnaires were taken from GPs (n= 15), nurses (n = 6) and geriatricians (n = 2). These professionals were also interviewed. In addition patients (n = 11 out of total n = 54) and their carers (n = 37) were interviewed.

RESULTS

GPs appreciated the support by the DGIP for problems in cognition, mood and mobility. Lack of knowledge and time restriction was the cause of their incapability at that point. In the cooperation between professionals, nurses felt that they had to initiate the contact. Personal contact helped the mutual communication. Involving the carer of the patient proved very important. All disciplines found this of crucial importance in order to deliver a tailored intervention and create conditions for optimal care. Barriers, for which the programme was tailored during the implementation, were: resistance in referrals of patients to the programme, nurses' and GPs' knowledge of diagnostic tests, communication problems and insufficient involvement of caregivers.

CONCLUSIONS

The implementation of the DGIP was feasible, but several barriers need ongoing attention by implementation, like communication between disciplines.

摘要

目的

确定荷兰老年干预计划(DGIP)在初级保健中的可行性。在DGIP中,一名护士与一名全科医生(GP)和一名临床老年病医生合作,对社区居住的老年患者进行护理评估和管理。本研究的目的是描述护理接受者和专业人员的观点,以确定促进DGIP实施的因素和障碍。

方法

采用定量和定性数据收集相结合的方法。对全科医生(n = 15)、护士(n = 6)和老年病医生(n = 2)进行问卷前测和后测。这些专业人员也接受了访谈。此外,还对患者(共54名中的11名)及其护理人员(n = 37)进行了访谈。

结果

全科医生赞赏DGIP对认知、情绪和行动能力问题的支持。当时,知识缺乏和时间限制是他们无法提供支持的原因。在专业人员的合作中,护士觉得他们必须发起联系。个人联系有助于相互沟通。事实证明,让患者的护理人员参与进来非常重要。所有学科都认为这对于提供量身定制的干预措施和创造最佳护理条件至关重要。在实施过程中针对该计划进行调整的障碍包括:将患者转诊至该计划时的阻力、护士和全科医生对诊断测试的了解、沟通问题以及护理人员参与不足。

结论

DGIP的实施是可行的,但一些障碍需要在实施过程中持续关注,比如学科之间的沟通。

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