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360度全方位照护:一种以患者为中心的护理模式,旨在促进老年人的健康。

COLLAGE 360: A Model of Person-Centered Care To Promote Health Among Older Adults.

作者信息

Howard Elizabeth P, Schreiber Robert, Morris John N, Russotto Aline, Flashner-Fineman Susan

机构信息

Northeastern University School of Nursing, 360 Huntington Avenue, Boston, MA 02115.

Institute for Aging Research, Hebrew SeniorLife, 1200 Centre Street, Boston, MA 02131.

出版信息

J Ageing Res Healthc. 2016;1(1):21-30. doi: 10.14302/issn.2474-7785.jarh-16-1123. Epub 2016 Jul 27.

Abstract

Health care leaders and providers have introduced the assumption the typical elder, even in the presence of complex, chronic disease and prevailing illness, is capable of assuming greater personal responsibility for their health care, with a shift from provider-centered to a person-centered model of care. For older adults who often and repeatedly face challenges managing and maintaining their health status, guidance and support is needed. In this study, , a comprehensive assessment system and wellness coaching program that focuses on prevention and wellness, care coordination and self-management of health care was implemented in one continuing care retirement community. Following completion of two assessment tools via directed conversation with a wellness coach, older adults developed an individualized vitality plan that outlined life goals, supporting goals and action plans for goal achievement. Results from this program suggest engagement in the assessment and wellness coaching process via the program translated into sample older adults sensing that they live in a more supportive environment when compared with elders not receiving any wellness coaching. In addition, the older adults had positive effects in the areas of mood, loneliness, social interaction, health status, and life satisfaction. Strategies to improve health and well being need an extended focus beyond the older adult's medical conditions and consider psychological, spiritual and social needs with personal preferences being paramount. These issues are foundational to a person-centered, health promotion approach needed among this population.

摘要

医疗保健领导者和提供者提出了这样一种假设

即使患有复杂的慢性疾病和常见疾病,典型的老年人也能够对自己的医疗保健承担更大的个人责任,医疗模式正从以提供者为中心向以患者为中心转变。对于经常反复面临管理和维持健康状况挑战的老年人来说,他们需要指导和支持。在本研究中,一个持续照料退休社区实施了一个全面的评估系统和健康指导计划,该计划侧重于预防和健康、医疗协调以及医疗保健的自我管理。通过与健康教练进行定向对话完成两项评估工具后,老年人制定了个性化的活力计划,该计划概述了生活目标、支持目标以及实现目标的行动计划。该计划的结果表明,与未接受任何健康指导的老年人相比,参与该计划评估和健康指导过程的老年人样本感觉自己生活在一个更具支持性的环境中。此外,老年人在情绪、孤独感、社交互动、健康状况和生活满意度等方面都产生了积极影响。改善健康和幸福的策略需要将关注点从老年人的医疗状况扩展到更广泛的领域,要考虑到心理、精神和社会需求,其中个人偏好至关重要。这些问题是该人群所需的以患者为中心的健康促进方法的基础。

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