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在一项全国性改善计划实施后,护理专业人员和老年人在老年人护理方面的观点存在差异。

Perspectives of nursing professionals and older adults differ on aspects of care for older people after a nationwide improvement program.

作者信息

Verweij Lisanne Marlieke, Wehrens Rik, Oldenhof Lieke, Bal Roland, Francke Anneke L

机构信息

Netherlands Institute of Health Services Research (NIVEL), Otterstraat 118-124, 3513, CR, Utrecht, the Netherlands.

Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.

出版信息

BMC Health Serv Res. 2018 May 2;18(1):321. doi: 10.1186/s12913-018-3114-x.

Abstract

BACKGROUND

The perspectives of nursing professionals might differ from those of older adults when it comes to care for older people. This cross-sectional study compares the views of older adults with the views of nursing professionals on the quality of care after a nationwide improvement program for care for older people was implemented (2008-2016) in the Netherlands.

METHODS

Questionnaire data were used from 385 nursing professionals (response rate 51%) that were part of the Nursing Staff Panel, a nationwide representative group of nursing staff, and working in home care, hospitals or general practices. Additionally, questionnaire data were used from 73 older adults (response rate 81%) who were involved in regional networks to discuss project proposals and to represent the voice of older adults in the nationwide improvement program. Participants were asked to evaluate care for older people with regard to collaboration between healthcare organizations and with regard to the tailored service, accessibility, and quality of care within their organizations and in the region in which they lived.

RESULTS

A majority of older adults (54%) and nursing professionals (61%) felt that collaboration with others had improved over the last few years. Approximately one third of the older adults stated that care for older people was tailored to fit individual needs and was accessible most of the time or always, as opposed to approximately two thirds of the professionals. Moreover, 17% older adults thought that the quality of care was good, compared with 54% of the nursing professionals. 77% of the nursing professionals and 94% of the older adults thought that improvements were still needed in care for older people, for example better integration of the different aspects of care and a more patient-centered approach.

CONCLUSION

Older adults who were involved in networks of the improvement program generally gave a less positive evaluation of aspects of care for older people and its development than nursing professionals. Considering differences in the perspectives of key stakeholders is relevant for the development and evaluation of nationwide improvement programs, for a correct interpretation of findings, and for making appropriate recommendations.

摘要

背景

在老年人护理方面,护理专业人员的观点可能与老年人不同。这项横断面研究比较了荷兰在实施全国性老年人护理改善计划(2008 - 2016年)后,老年人与护理专业人员对护理质量的看法。

方法

使用了来自385名护理专业人员(回复率51%)的问卷数据,这些人员是护理人员小组的一部分,该小组是全国护理人员的代表性群体,在家庭护理、医院或全科医疗工作。此外,还使用了来自73名老年人(回复率81%)的问卷数据,他们参与了区域网络,以讨论项目提案并在全国性改善计划中代表老年人的声音。参与者被要求就医疗保健组织之间的合作以及他们所在组织和居住地区内护理的个性化服务、可及性和质量对老年人护理进行评估。

结果

大多数老年人(54%)和护理专业人员(61%)认为在过去几年中与他人的合作有所改善。约三分之一的老年人表示,老年人护理是根据个人需求量身定制的,并且在大多数时候或总是可以获得,而护理专业人员中这一比例约为三分之二。此外,17%的老年人认为护理质量良好,而护理专业人员中这一比例为54%。77%的护理专业人员和94%的老年人认为老年人护理仍需改进,例如更好地整合护理的不同方面以及采用更以患者为中心的方法。

结论

参与改善计划网络的老年人对老年人护理及其发展方面的评价总体上不如护理专业人员积极。考虑关键利益相关者观点的差异对于全国性改善计划的制定和评估、对研究结果的正确解读以及提出适当建议具有重要意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1caf/5932835/c4774edf74e3/12913_2018_3114_Fig1_HTML.jpg

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