Lau Janice Ying-Chui, Wong Eliza Lai-Yi, Chung Roger Y, Law Stephen C K, Threapleton Diane, Kiang Nicole, Chau Patsy, Wong Samuel Y S, Woo Jean, Yeoh Eng-Kiong
JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong.
Centre of Urban History, Culture and Media, Institute of Future Cities, The Chinese University of Hong Kong, Shatin, Hong Kong.
Int J Health Plann Manage. 2018 Apr 27. doi: 10.1002/hpm.2534.
To examine the barriers that hinder collaboration between health care and social care services and to report recommendations for effective collaboration to meet the growing support and care needs of our ageing population.
Data for this qualitative study were obtained from interviews with 7 key informants (n = 42) and 22 focus groups (n = 117) consisting of service providers who were from the health care or social care sectors and supporting elderly patients with multiple chronic diseases or long-term care needs. Data collection was conducted from 2015 to 2016. The data were analysed using an inductive approach on the basis of thematic analysis.
Qualitative analysis reviewed a number of factors that play a significant role in setting up barriers at the operational level, including fragmentation and lack of sustainability of discharge programmes provided by non-governmental organisations, lack of capacity of homes for the elderly, limitation of time and resources, and variation of roles in supporting end-of-life care decisions between the medical and social sectors. Other barriers are those of communication to be found at the structural level and perceptual ones that exist between professionals. Of these, perceptual barriers affect attitudes and create mistrust and interprofessional stereotypes and a hierarchy between the health care and social care sectors.
Health care and social care service providers recognise the need for collaborative work to enhance continuity of care and ageing in place; however, their efforts are hindered by the identified barriers that need to be dealt with in practical terms and by a change of policy.
探讨阻碍医疗保健与社会护理服务之间合作的障碍，并报告为有效合作提出的建议，以满足我国老龄化人口日益增长的支持和护理需求。
本定性研究的数据来自对7名关键 informant（n = 42）和22个焦点小组（n = 117）的访谈，这些焦点小组由来自医疗保健或社会护理部门、为患有多种慢性病或有长期护理需求的老年患者提供支持的服务提供者组成。数据收集于2015年至2016年进行。数据采用基于主题分析的归纳法进行分析。
定性分析审查了一些在操作层面设置障碍方面起重要作用的因素，包括非政府组织提供的出院计划的碎片化和缺乏可持续性、养老院能力不足、时间和资源有限，以及医疗和社会部门在支持临终护理决策方面的角色差异。其他障碍是在结构层面发现的沟通障碍以及专业人员之间存在的认知障碍。其中，认知障碍影响态度，造成不信任、跨专业刻板印象以及医疗保健和社会护理部门之间的等级制度。
医疗保健和社会护理服务提供者认识到需要开展合作工作，以提高护理的连续性并实现就地养老；然而，他们的努力受到已确定的障碍的阻碍，这些障碍需要切实加以解决，并通过政策变革来克服。
