Centre for Research in Primary & Community Care, University of Hertfordshire, Hatfield, UK.
J Interprof Care. 2011 Jul;25(4):280-6. doi: 10.3109/13561820.2011.562332. Epub 2011 May 9.
New models of interprofessional working are continuously being proposed to address the burgeoning health and social care needs of older people with complex and long-term health conditions. Evaluations of the effectiveness of these models tend to focus on process measures rather than outcomes for the older person. This discussion paper argues that the concept of frailty, and measures based on it, may provide a more user-centred tool for the evaluation of interprofessional services - a tool that cuts across unidisciplinary preoccupations and definitions of effectiveness. Numerous frailty scales have been developed for case identification and stratification of risk of adverse outcomes. We suggest that they may also be particularly suitable for evaluating the effectiveness of interprofessional working with community-dwelling older people. Several exemplars of frailty scales that might serve this purpose are identified, and their potential contributions and limitations are discussed. Further work is required to establish which is the most suitable scales for this application. The development of an appropriate frailty scale could provide an opportunity for interprofessional debate about the forms of care and treatment that should be prioritised to improve the health and well-being of this population.
新的跨专业工作模式不断被提出，以满足有复杂和长期健康状况的老年人不断增长的健康和社会关怀需求。这些模式的有效性评估往往侧重于过程措施，而不是老年人的结果。本文认为，虚弱的概念，以及基于该概念的措施，可能为跨专业服务的评估提供一个更以用户为中心的工具——一个跨越多学科关注和有效性定义的工具。已经开发了许多虚弱量表来进行病例识别和不良后果风险的分层。我们认为，它们也可能特别适合评估与社区居住的老年人进行跨专业合作的效果。确定了几个可能适用于此目的的虚弱量表范例，并讨论了它们的潜在贡献和局限性。需要进一步的工作来确定哪种量表最适合这种应用。开发一个合适的虚弱量表可以为跨专业讨论提供机会，讨论应该优先考虑哪些形式的护理和治疗来改善这一人群的健康和福祉。
