Centre for Care Research, Gjøvik University College, Norway; Faculty of Medicine, Institute of Health and Society, Department of Nursing Science, University of Oslo, Norway.
J Adv Nurs. 2014 Mar;70(3):553-63. doi: 10.1111/jan.12214. Epub 2013 Jul 22.
To provide a method for assessing the degree of interpersonal continuity adapted to context and to measure and assess the degree of interpersonal continuity for long-term recipients dependent on daily home health care.
Interpersonal continuity is important to the quality of care for long-term dependents. In high-frequency home healthcare services where patients receive daily care from many nurses or other health personnel over time, interpersonal continuity may be difficult to attain.
A cross-sectional study with a descriptive design.
Information concerning 79 patients receiving long-term frequent care was collected during four weeks in a maximum variation sample of Norwegian municipalities, from January 2009-May 2010. We measured interpersonal continuity objectively using indices of dispersion and the next-day sequence of health personnel. For each measure, we computed the highest feasible level of continuity that could be attained in this home healthcare context given a standard shift plan. This level was then used as benchmark against which the actual level of continuity was assessed.
Patients received on average 51 visits from a mean of 17 different carers during four weeks. The results revealed a low degree of interpersonal continuity in practice, far below what was feasible according to the benchmarks.
High-frequency home health care was characterized by interpersonal discontinuity, but with potential for improvement. Objective measures of interpersonal continuity, when the benchmark is adapted to the context, are useful tools for planning and surveying continuity of care.
提供一种适用于情境的人际连续性评估方法，并测量和评估长期依赖日常家庭保健的接受者的人际连续性程度。
人际连续性对长期依赖者的护理质量很重要。在高频家庭保健服务中，随着时间的推移，患者会接受许多护士或其他卫生人员的日常护理，人际连续性可能难以实现。
一项具有描述性设计的横断面研究。
在 2009 年 1 月至 2010 年 5 月期间，我们在挪威各城市的最大变异样本中，对 79 名接受长期高频护理的患者进行了为期四周的信息收集。我们使用离散度指数和下一天卫生人员的顺序来客观测量人际连续性。对于每个措施，我们计算了在这种家庭保健环境下，根据标准轮班计划可以达到的最高可能连续性水平。然后，将此水平用作评估实际连续性水平的基准。
患者在四周内平均接受了 51 次来自 17 位不同护理人员的护理。结果显示，实际的人际连续性程度较低，远低于基准所显示的可行程度。
高频家庭保健服务的特点是人际不连续性，但具有改进的潜力。当基准适用于情境时，人际连续性的客观测量是规划和调查护理连续性的有用工具。
