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评估医疗保健护照以改善痴呆症患者的护理质量和沟通(EQuIP):一项定性纵向研究的方案文件

The evaluation of a healthcare passport to improve quality of care and communication for people living with dementia (EQuIP): a protocol paper for a qualitative, longitudinal study.

作者信息

Leavey Gerard, Abbott Aine, Watson Max, Todd Stephen, Coates Vivien, McIlfactrick Sonja, McCormack Brendan, Waterhouse-Bradley Bethany, Curran Emma

机构信息

The Bamford Centre for Mental Health & Wellbeing, Ulster University, Cromore Road, Coleraine, Northern Ireland.

Royal College of Practitioners, Belfast, Northern Ireland.

出版信息

BMC Health Serv Res. 2016 Aug 9;16(a):363. doi: 10.1186/s12913-016-1617-x.

Abstract

BACKGROUND

There is an urgent need for the development of simple communication tools that convey the strengths, assets, and healthcare needs of people living with dementia. A Healthcare Passport may improve communication with range of health and social support services, enhancing quality and continuity of care, and to permit a consideration of the challenges and how these might be managed effectively and compassionately. This study aims to evaluate the acceptability and use of this type of intervention for people living with dementia and their carers.

METHODS/DESIGN: This is a qualitative longitudinal study informed by a critical realist review. The participants will be individuals identified as having mild-moderate dementia and informal carers. The in-depth interviews will occur at three points over the course of 18 months as they use the passport. This will be supplemented by analysis of the content of the passports and information from health and social care providers on the daily practicalities of using the passport in a range of healthcare settings.

DISCUSSION

By using a critical realist review and a qualitative, longitudinal approach, the study allows for the assessment of a complex intervention in a manner which goes beyond evaluating the basic efficacy of the passport, but looking more deeply at how it worked, for whom, and in what context. It has the potential to develop new data on how interventions improve communication across a range of service providers, while encouraging health and social care professionals to respect and encourage the development of self-management and retention of personhood throughout the progression of life-limiting illnesses.

摘要

背景

迫切需要开发简单的沟通工具,以传达痴呆症患者的优势、资产和医疗保健需求。医疗保健护照可能会改善与一系列健康和社会支持服务的沟通,提高护理质量和连续性,并允许考虑挑战以及如何有效且富有同情心地应对这些挑战。本研究旨在评估这种干预措施对痴呆症患者及其护理人员的可接受性和使用情况。

方法/设计:这是一项基于批判实在论综述的定性纵向研究。参与者将是被确定患有轻度至中度痴呆症的个体和非正式护理人员。在他们使用护照的过程中,将在18个月内分三个时间点进行深入访谈。这将通过对护照内容的分析以及来自健康和社会护理提供者的关于在一系列医疗保健环境中使用护照的日常实际情况的信息来补充。

讨论

通过使用批判实在论综述和定性纵向方法,该研究能够以一种超越评估护照基本功效的方式评估复杂干预措施,而是更深入地研究它如何发挥作用、对谁发挥作用以及在何种背景下发挥作用。它有可能生成关于干预措施如何改善与一系列服务提供者沟通的新数据,同时鼓励健康和社会护理专业人员在限制生命疾病的整个病程中尊重并鼓励自我管理的发展和人格的保留。

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