Risco Ester, Zabalegui Adelaida, Miguel Susana, Farré Marta, Alvira Carme, Cabrera Esther
Departamento de Enfermería, Hospital Clínic de Barcelona, Barcelona, España.
Escuela de Ciencias de la Salud Gimbernat i Tomàs Cerdà, Universitat Autònoma de Barcelona, Sant Cugat del Vallès (Barcelona), España.
Gac Sanit. 2017 Nov-Dec;31(6):518-523. doi: 10.1016/j.gaceta.2016.07.006. Epub 2016 Oct 15.
To describe the implementation of the Balance of Care model in decision-making regarding the best care for patients with dementia in Spain.
The Balance of Care model was used, which consists of (1) describing the profile of the typical cases of people with dementia and their caregivers, (2) identifying the most suitable care setting for each of the cases (home-care or long-term care institution), (3) designing specific care plans for each case, and (4) evaluating the cost of the proposed care plans.
A total of 1,641 people with dementia and their caregivers from eight European countries were used in the case design. The evaluation of cases was conducted by 20 experts in different medical fields of dementia. In Spain, the results indicated that initially the most suitable placement to take care of people with dementia was the home, however in cases with higher dependency in activities of daily living, the long-term care setting was the best option. For the best care plan, the following resources were chosen: professional help to perform basic activities; day center; multidisciplinary home care team; financial support; community nurse; and social worker.
The Balance of Care method allows us to assess the most appropriate place of care for people with dementia systematically, objectively and with a multidisciplinary team. Other cost-effective interventions should be integrated in patients with dementia care in order to improve home care.
描述“照护平衡”模型在西班牙为痴呆症患者选择最佳照护方案的决策过程中的应用。
采用“照护平衡”模型，该模型包括：（1）描述痴呆症患者及其照护者的典型案例概况；（2）为每个案例确定最合适的照护环境（居家照护或长期照护机构）；（3）为每个案例设计具体的照护计划；（4）评估所提议照护计划的成本。
案例设计中使用了来自八个欧洲国家的1641名痴呆症患者及其照护者。案例评估由20名痴呆症不同医学领域的专家进行。在西班牙，结果表明，最初照顾痴呆症患者最合适的安置场所是家庭，然而在日常生活活动依赖程度较高的情况下，长期照护环境是最佳选择。对于最佳照护计划，选择了以下资源：提供基本活动的专业帮助；日间照料中心；多学科居家照护团队；经济支持；社区护士；以及社会工作者。
“照护平衡”方法使我们能够通过多学科团队系统、客观地评估痴呆症患者最合适的照护场所。应将其他具有成本效益的干预措施纳入痴呆症患者的照护中，以改善居家照护。
