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德国短期护理范围内针对痴呆症患者的低门槛支持服务——一项关于不同利益相关者观点的定性研究

Low-threshold support services for people with dementia within the scope of respite care in Germany - A qualitative study on different stakeholders' perspective.

作者信息

Hochgraeber Iris, von Kutzleben Milena, Bartholomeyczik Sabine, Holle Bernhard

机构信息

German Center for Neurodegenerative Diseases; Witten/Herdecke University, Germany.

German Center for Neurodegenerative Diseases, Germany.

出版信息

Dementia (London). 2017 Jul;16(5):576-590. doi: 10.1177/1471301215610234. Epub 2015 Oct 12.

Abstract

Low-threshold support services are provided within the basket of services of German long-term care insurance as a part of respite care to support family carers and people with dementia. This study investigates various stakeholders' (providers, coordinators, volunteers, family carers and people with dementia) perspectives on low-threshold support service regarding its organisation and conceptualisation as well as how stakeholders and users value low-threshold support service using a qualitative approach. Twelve guided interviews and group discussions were conducted with 31 participants. Organisation and conceptualisation are characterised by the lowness of the service thresholds, which is perceived to be quick and simple forms of support with no user requirements. Multiple barriers such as the challenging behaviour of people with dementia and their initial refusal as well as their holding low-threshold support service in low esteem can hinder the utilisation of these services. Low-threshold support service within the scope of the long-term care insurance law can be separated into two types: low-cost (non-professional) services and high-cost services with comprehensive training for 'employed' volunteers (professional). Both types are constantly developing within the landscape of the German long-term care system, and low-threshold support service appears to be adapted to diverse needs. Therefore, it is important to avoid replacing non-professional services with professional services.

摘要

作为喘息服务的一部分,德国长期护理保险服务范围内提供了低门槛支持服务,以帮助家庭护理人员和痴呆症患者。本研究采用定性方法,调查了各利益相关者(提供者、协调员、志愿者、家庭护理人员和痴呆症患者)对低门槛支持服务在组织和概念化方面的看法,以及利益相关者和用户如何评价低门槛支持服务。对31名参与者进行了12次引导式访谈和小组讨论。组织和概念化的特点是服务门槛低,被认为是快速简单的支持形式,对用户没有要求。多种障碍,如痴呆症患者具有挑战性的行为、他们最初的拒绝以及他们对低门槛支持服务的轻视,都可能阻碍这些服务的使用。长期护理保险法范围内的低门槛支持服务可分为两类:低成本(非专业)服务和为“受雇”志愿者提供全面培训的高成本服务(专业)。这两种类型在德国长期护理系统中都在不断发展,低门槛支持服务似乎在适应多样化的需求。因此,避免用专业服务取代非专业服务很重要。

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