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欧洲城市健康中心(UHCE)的评估设计:为欧洲五个城市中居住在社区的老年人提供预防性综合健康和社会护理。

Evaluation design of Urban Health Centres Europe (UHCE): preventive integrated health and social care for community-dwelling older persons in five European cities.

作者信息

Franse Carmen B, Voorham Antonius J J, van Staveren Rob, Koppelaar Elin, Martijn Rens, Valía-Cotanda Elisa, Alhambra-Borrás Tamara, Rentoumis Tasos, Bilajac Lovorka, Marchesi Vanja Vasiljev, Rukavina Tomislav, Verma Arpana, Williams Greg, Clough Gary, Garcés-Ferrer Jorge, Mattace Raso Francesco, Raat Hein

机构信息

Department of Public Health, Erasmus University Medical Center, Wytemaweg 80, 3015, CN, Rotterdam, The Netherlands.

Rotterdam University of Applied Sciences, Research Centre Innovation in Care, Rotterdam, The Netherlands.

出版信息

BMC Geriatr. 2017 Sep 11;17(1):209. doi: 10.1186/s12877-017-0606-1.

Abstract

BACKGROUND

Older persons often have interacting physical and social problems and complex care needs. An integrated care approach in the local context with collaborations between community-, social-, and health-focused organisations can contribute to the promotion of independent living and quality of life. In the Urban Health Centres Europe (UHCE) project, five European cities (Greater Manchester, United Kingdom; Pallini (in Greater Athens Area), Greece; Rijeka, Croatia; Rotterdam, the Netherlands; and Valencia, Spain) develop and implement a care template that integrates health and social care and includes a preventive approach. The UHCE project includes an effect and process evaluation.

METHODS

In a one-year pre-post controlled trial, in each city 250 participants aged 75+ years are recruited to receive the UHCE approach and are compared with 250 participants who receive 'care as usual'. Benefits of UHCE approach in terms of healthy life styles, fall risk, appropriate medication use, loneliness level and frailty, and in terms of level of independence and health-related quality of life and health care use are assessed. A multilevel modeling approach is used for the analyses. The process evaluation is used to provide insight into the reach of the target population, the extent to which elements of the UHCE approach are executed as planned and the satisfaction of the participants.

DISCUSSION

The UHCE project will provide new insight into the feasibility and effectiveness of an integrated care approach for older persons in different European settings.

TRIAL REGISTRATION

ISRCTN registry number is ISRCTN52788952 . Date of registration is 13/03/2017.

摘要

背景

老年人常常存在相互影响的身体和社会问题以及复杂的护理需求。在当地环境中采用综合护理方法,通过社区、社会和健康相关组织之间的合作,有助于促进独立生活和提高生活质量。在欧洲城市健康中心(UHCE)项目中,五个欧洲城市(英国大曼彻斯特;希腊大雅典地区的帕利尼;克罗地亚里耶卡;荷兰鹿特丹;西班牙巴伦西亚)制定并实施了一个整合健康和社会护理并包含预防方法的护理模板。UHCE项目包括效果和过程评估。

方法

在一项为期一年的前后对照试验中,每个城市招募250名75岁及以上的参与者接受UHCE方法,并与250名接受“常规护理”的参与者进行比较。评估UHCE方法在健康生活方式、跌倒风险、合理用药、孤独程度和虚弱状况方面,以及在独立程度、与健康相关的生活质量和医疗保健使用方面的益处。采用多层次建模方法进行分析。过程评估用于深入了解目标人群的覆盖范围、UHCE方法的各项要素按计划执行的程度以及参与者的满意度。

讨论

UHCE项目将为不同欧洲环境下针对老年人的综合护理方法的可行性和有效性提供新的见解。

试验注册

ISRCTN注册号为ISRCTN52788952。注册日期为2017年3月13日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cf3/5594491/9000223868f3/12877_2017_606_Fig1_HTML.jpg

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