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改善长期护理转诊流程:患者及护理人员的见解

Improving the long-term care referral process: insights from patients and caregivers.

作者信息

Guihan Marylou, Hedrick Susan, Miller Sara, Reder Sheri

机构信息

Center for Management of Complex Chronic Care (CMC3), Edward Hines, Jr. VA Hospital, Hines, Illinois 60141-3030, USA.

出版信息

Gerontol Geriatr Educ. 2011;32(2):135-51. doi: 10.1080/02701960.2011.572041.

Abstract

Large increases in the need for long-term care (LTC) services are expected as baby boomers age. Little has been published about patient and caregiver preferences for information about LTC. However, our qualitative research findings suggest that potential consumers may find it difficult to obtain accurate and timely information about LTC programs and services. In-person, semistructured interviews were conducted with 47 subjects, including patients (n = 25) within 90 days of their referral to a LTC placement (including NH, assisted living, home care, and community) and their caregivers (n = 22). Interview questions addressed the events that seemed to trigger their need for a LTC referral, the resources they used to become more informed about LTC options and the issues they confronted with the LTC referral process. Qualitative analyses identified a number of patient and informal caregiver-reported barriers to making decisions about LTC services, including insufficient information about LTC programs and community resources, unclear funding requirements and inadequate funding, and difficulty knowing how to plan for LTC or make LTC decisions. A potential solution may be an online LTC Guide designed to provide accurate information about the range of LTC services, with an emphasis on home and community-based services. This Guide was developed to address the gap in comprehensive LTC information identified in the findings of this study.

摘要

随着婴儿潮一代步入老年,预计长期护理(LTC)服务的需求将大幅增加。关于患者和护理人员对长期护理信息的偏好,此前发表的内容较少。然而,我们的定性研究结果表明,潜在消费者可能会发现难以获得有关长期护理项目和服务的准确及时信息。我们对47名受试者进行了面对面的半结构化访谈,其中包括在被转介至长期护理机构(包括疗养院、辅助生活设施、家庭护理和社区服务)后90天内的患者(n = 25)及其护理人员(n = 22)。访谈问题涉及似乎引发他们对长期护理转介需求的事件、他们用来更深入了解长期护理选项的资源以及他们在长期护理转介过程中面临的问题。定性分析确定了一些患者和非正式护理人员报告的在做出长期护理服务决策时的障碍,包括关于长期护理项目和社区资源的信息不足、资金要求不明确和资金不足,以及难以知道如何规划长期护理或做出长期护理决策。一个潜在的解决方案可能是一个在线长期护理指南,旨在提供有关长期护理服务范围的准确信息,重点是基于家庭和社区的服务。本指南的制定是为了解决本研究结果中发现的全面长期护理信息方面的差距。

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