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迅速获得帮助:老年人和社区工作者对跌倒管理应急计划的看法。

Getting help quickly: older people and community worker perspectives of contingency planning for falls management.

作者信息

Charlton Kimberly, Murray Carolyn M, Kumar Saravana

机构信息

a Domiciliary Care, Department of Communities and Social Inclusion , South Australian Government , Northfield, Adelaide , Australia.

b School of Health Sciences, International Centre for Allied Health Evidence , University of South Australia , Adelaide , Australia.

出版信息

Disabil Rehabil. 2018 Jan;40(2):159-167. doi: 10.1080/09638288.2016.1247470. Epub 2016 Nov 10.

Abstract

PURPOSE

Older people living in the community need to plan for getting help quickly if they have a fall. In this paper planning for falls is referred to as contingency planning and is not a falls prevention strategy but rather a falls management strategy. This research explored the perspectives of older people and community workers (CWs) about contingency planning for a fall.

METHOD

Using a qualitative descriptive approach, participants were recruited through a community agency that supports older people. In-depth interviews were conducted with seven older people (67-89 years of age) and a focus group was held with seven workers of mixed disciplines from the same agency. Older people who hadn't fallen were included but were assumed to be at risk of falls because they were in receipt of services. Thematic analysis and concept mapping combined the data from the two participant groups.

RESULTS

Four themes including preconceptions about planning ahead for falling, a fall changes perception, giving, and receiving advice about contingency plans and what to do about falling.

CONCLUSION

Both CWs and older people agree contingency planning requires understanding of individual identity and circumstances. CWs have limited knowledge about contingency planning and may be directive, informative, or conservative. Implications for Rehabilitation Falls can result in serious consequences for older people. There is an evidence-practice gap as availability of and access to contingency planning does not necessarily mean older people will use it in a falls emergency. Older people prefer community workers to be directive or informative about contingency planning options but they do want choice and control. Increased community workers knowledge of, and collaborative decision-making about, contingency planning may promote patient-centered services and assist in closing the evidence-practice gap.

摘要

目的

居住在社区中的老年人需要制定计划,以便在跌倒时能迅速获得帮助。本文中,跌倒计划被称为应急计划,它不是一种预防跌倒的策略,而是一种跌倒管理策略。本研究探讨了老年人和社区工作者对应急计划的看法。

方法

采用定性描述方法,通过一个支持老年人的社区机构招募参与者。对7名老年人(67 - 89岁)进行了深入访谈,并与该机构7名不同专业的工作人员进行了焦点小组讨论。纳入了未跌倒的老年人,但由于他们接受服务,被认为有跌倒风险。主题分析和概念映射结合了两个参与者群体的数据。

结果

四个主题包括对提前为跌倒做计划的先入之见、跌倒改变认知、就应急计划提供和接受建议以及跌倒时该怎么做。

结论

社区工作者和老年人都认为应急计划需要了解个人身份和情况。社区工作者对应急计划的了解有限,可能具有指导性、提供信息性或保守性。康复的意义跌倒可能给老年人带来严重后果。存在证据与实践的差距,因为应急计划的可用性和获取并不一定意味着老年人会在跌倒紧急情况中使用它。老年人希望社区工作者对应急计划选项具有指导性或提供信息,但他们确实希望有选择和控制权。增加社区工作者对应急计划的了解以及协作决策可能会促进以患者为中心的服务,并有助于缩小证据与实践的差距。

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