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[养老院与医生成功合作的先决条件是什么?——巴伐利亚养老院混合方法横断面研究的结果]

[What are the Prerequisites for a Successful Cooperation between Nursing Homes and Physicians? - Results of a Mixed-methods Cross-Sectional Study in Bavarian Nursing Homes].

作者信息

Karsch-Völk M, Lüssenheide J, Linde K, Schmid E, Schneider A

机构信息

Institut für Allgemeinmedizin, Klinikum rechts der Isar, Technische Universität München, München.

出版信息

Gesundheitswesen. 2016 Nov;78(11):742-748. doi: 10.1055/s-0035-1548856. Epub 2015 May 7.

Abstract

This mixed-methods cross-sectional study examined the cooperation between nursing home staff and physicians in Bavarian nursing homes in order to understand which organisational and communication measures are resulting in satisfying teamwork among professional groups in nursing homes. In 3 interview rounds nursing home staff, general practitioners, medical specialists, dentists, nursing home residents, and relatives in 52 nursing homes were interviewed using a questionnaire that was enhanced after every round. Additionally, focus group interviews have been performed in 2 nursing homes. 443 persons involved in patient care, 50 residents and 47 relatives participated in the structured interviews. 22 persons attended the focus group interviews. 65% of the nursing homes required regular visits of general practitioners and 36% or, respectively, 27% required regular or on demand visits of specialists. 47% of the nursing home staff that was asked about this issue stated that it would make their work easier if only a small number of physicians were in charge of their institution. Measures for improvement of medical care in nursing homes most frequently suggested by interview partners responsible for patient care were: better communication (9%), better remuneration of physicians' nursing home visits (7%, nurses and physicians) and less bureaucracy and regular physicians' visits (5% in each question). Because of the composition of our study sample it cannot be assumed that the results are representative for all Bavarian nursing homes. Confidence in one another, low number of persons in charge, binding agreements and regular physicians' nursing home visits are essential for a successful cooperation between providing physicians and nursing home staff.

摘要

这项混合方法的横断面研究调查了巴伐利亚养老院中护理人员与医生之间的合作情况,以便了解哪些组织和沟通措施能促成养老院各专业群体间令人满意的团队合作。在三轮访谈中,研究人员使用一份每轮后都会改进的问卷,对52家养老院的护理人员、全科医生、医学专家、牙医、养老院居民及其亲属进行了访谈。此外,还在两家养老院进行了焦点小组访谈。443名参与患者护理的人员、50名居民和47名亲属参加了结构化访谈。22人参加了焦点小组访谈。65%的养老院需要全科医生定期来访,36%或27%的养老院分别需要专科医生定期或按需来访。在被问及此问题的护理人员中,47%表示,如果只有少数医生负责他们所在的机构,他们的工作会更轻松。负责患者护理的访谈对象最常提出的改善养老院医疗护理的措施有:改善沟通(9%)、提高医生家访的报酬(7%,护士和医生)以及减少官僚作风和增加医生定期来访(每个问题均为5%)。由于我们研究样本的构成,不能假定结果对所有巴伐利亚养老院都具有代表性。相互信任、负责人数量少、有约束力的协议以及医生定期家访对于提供医疗服务的医生和养老院工作人员之间的成功合作至关重要。

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