改善早期检测措施：一项探索老年人和专业人员观点的定性研究
Improving early detection initiatives: a qualitative study exploring perspectives of older people and professionals.
作者信息
Lette Manon, Stoop Annerieke, Lemmens Lidwien C, Buist Yvette, Baan Caroline A, de Bruin Simone R
机构信息
Amsterdam Public Health research institute, Department of General Practice and Elderly Care Medicine, VU University Medical Center, Amsterdam, the Netherlands.
Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
出版信息
BMC Geriatr. 2017 Jun 23;17(1):132. doi: 10.1186/s12877-017-0521-5.
BACKGROUND
A wide range of initiatives on early detection and intervention have been developed to proactively identify problems related to health and wellbeing in (frail) older people, with the aim of supporting them to live independently for as long as possible. Nevertheless, it remains unclear what the best way is to design such initiatives and how older people's needs and preferences can be best addressed. This study aimed to address this gap in the literature by exploring: 1) older people's perspectives on health and living environment in relation to living independently at home; 2) older people's needs and preferences in relation to initiating and receiving care and support; and 3) professionals' views on what would be necessary to enable the alignment of early detection initiatives with older people's own needs and preferences.
METHODS
In this qualitative study, we conducted semi-structured interviews with 36 older people and 19 professionals in proactive elderly care. Data were analysed using the framework analysis method.
RESULTS
From the interviews with older people important themes in relation to health and living environment emerged, such as maintaining independence, appropriate housing, social relationships, a supporting network and a sense of purpose and autonomy. Older people preferred to remain self-sufficient, and they would rather not ask for help for psychological or social problems. However, the interviews also highlighted that they were not always able or willing to anticipate future needs, which can hinder early detection or early intervention. At the same time, professionals indicated that older people tend to over-estimate their self-reliance and therefore advocated for early detection and intervention, including social and psychological issues.
CONCLUSION
Older people have a broad range of needs in different domains of life. Discrepancies exist between older people and professionals with regard to their views on timing and scope of early detection initiatives. This study aimed to reveal starting-points for better alignment between initiatives and older people's needs and preferences. Such starting points may support policy makers and care professionals involved in early detection initiatives to make more informed decisions.
背景
已经开展了一系列早期检测和干预举措，以主动识别（体弱）老年人与健康和幸福相关的问题，目的是支持他们尽可能长时间地独立生活。然而，尚不清楚设计此类举措的最佳方式是什么，以及如何最好地满足老年人的需求和偏好。本研究旨在通过探讨以下内容填补文献中的这一空白：1）老年人对与在家独立生活相关的健康和生活环境的看法；2）老年人在启动和接受护理及支持方面的需求和偏好；3）专业人员对使早期检测举措与老年人自身需求和偏好保持一致所需条件的看法。
方法
在这项定性研究中，我们对36名老年人和19名主动老年护理专业人员进行了半结构化访谈。使用框架分析法对数据进行了分析。
结果
从对老年人的访谈中出现了与健康和生活环境相关的重要主题，如保持独立、合适的住房、社会关系、支持网络以及目标感和自主性。老年人更喜欢保持自给自足，对于心理或社会问题他们宁愿不寻求帮助。然而，访谈也强调他们并不总是能够或愿意预见未来的需求，这可能会阻碍早期检测或早期干预。与此同时，专业人员表示，老年人往往高估了自己的自立能力，因此主张进行早期检测和干预，包括社会和心理问题。
结论
老年人在生活的不同领域有广泛的需求。老年人和专业人员在早期检测举措的时机和范围的看法上存在差异。本研究旨在揭示使举措与老年人的需求和偏好更好地保持一致的起点。这些起点可能有助于参与早期检测举措的政策制定者和护理专业人员做出更明智的决策。
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