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对75岁及以上体弱社区居住成年人护理网络的监督:一项混合方法研究的方案

Supervision of care networks for frail community dwelling adults aged 75 years and older: protocol of a mixed methods study.

作者信息

Verver Didi, Merten Hanneke, Robben Paul, Wagner Cordula

机构信息

Department of Public and Occupational health, EMGO+Institute/VU University Medical Centre, Amsterdam, The Netherlands.

Dutch Healthcare Inspectorate (IGZ), Utrecht, The Netherlands Institute of Health Policy and Management (iBMG), Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands.

出版信息

BMJ Open. 2015 Aug 25;5(8):e008632. doi: 10.1136/bmjopen-2015-008632.

Abstract

INTRODUCTION

The Dutch healthcare inspectorate (IGZ) supervises the quality and safety of healthcare in the Netherlands. Owing to the growing population of (community dwelling) older adults and changes in the Dutch healthcare system, the IGZ is exploring new methods to effectively supervise care networks that exist around frail older adults. The composition of these networks, where formal and informal care takes place, and the lack of guidelines and quality and risk indicators make supervision complicated in the current situation.

METHODS AND ANALYSIS

This study consists of four phases. The first phase identifies risks for community dwelling frail older adults in the existing literature. In the second phase, a qualitative pilot study will be conducted to assess the needs and wishes of the frail older adults concerning care and well-being, perception of risks, and the composition of their networks, collaboration and coordination between care providers involved in the network. In the third phase, questionnaires based on the results of phase II will be sent to a larger group of frail older adults (n=200) and their care providers. The results will describe the composition of their care networks and prioritise risks concerning community dwelling older adults. Also, it will provide input for the development of a new supervision framework by the IGZ. During phase IV, a second questionnaire will be sent to the participants of phase III to establish changes of perception in risks and possible changes in the care networks. The framework will be tested by the IGZ in pilots, and the researchers will evaluate these pilots and provide feedback to the IGZ.

ETHICS AND DISSEMINATION

The study protocol was approved by the Scientific Committee of the EMGO+institute and the Medical Ethical review committee of the VU University Medical Centre. Results will be presented in scientific articles and reports and at meetings.

摘要

引言

荷兰医疗保健检查局(IGZ)负责监督荷兰医疗保健的质量和安全。由于(居住在社区的)老年人数量不断增加以及荷兰医疗保健系统的变化,IGZ正在探索新方法,以有效监督围绕体弱老年人存在的护理网络。这些网络的构成、正式和非正式护理发生的地点,以及缺乏指导方针、质量和风险指标,使得当前情况下的监督工作变得复杂。

方法与分析

本研究包括四个阶段。第一阶段在现有文献中确定社区居住的体弱老年人面临的风险。第二阶段将进行一项定性试点研究,以评估体弱老年人在护理和福祉、风险认知、其网络构成、网络中护理提供者之间的协作与协调方面的需求和愿望。第三阶段,将根据第二阶段的结果向更大规模的体弱老年人群体(n = 200)及其护理提供者发送问卷。结果将描述他们护理网络的构成,并对社区居住老年人面临的风险进行优先级排序。此外,它将为IGZ制定新的监督框架提供依据。在第四阶段,将向第三阶段的参与者发送第二份问卷,以确定风险认知的变化以及护理网络可能的变化。该框架将由IGZ在试点中进行测试,研究人员将对这些试点进行评估,并向IGZ提供反馈。

伦理与传播

该研究方案已获得EMGO +研究所科学委员会和VU大学医学中心医学伦理审查委员会的批准。研究结果将在科学文章、报告以及会议上发表。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c38/4550721/63ca55c0b420/bmjopen2015008632f01.jpg

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