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基于网络的痴呆症护理对初级保健中更多整合、护理质量和协作的有效性的纵向多案例研究。

Longitudinal multiple case study on effectiveness of network-based dementia care towards more integration, quality of care, and collaboration in primary care.

机构信息

Radboud university medical center, Donders Institute for Brain Cognition and Behaviour, Department of Geriatric Medicine, Nijmegen, The Netherlands.

Radboud university medical center, Radboudumc Alzheimer Centre, Nijmegen, The Netherlands.

出版信息

PLoS One. 2018 Jun 27;13(6):e0198811. doi: 10.1371/journal.pone.0198811. eCollection 2018.

DOI:10.1371/journal.pone.0198811
PMID:29949608
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6021091/
Abstract

INTRODUCTION

This study aimed to provide insight into the merits of DementiaNet, a network-based primary care innovation for community-dwelling dementia patients.

METHODS

Longitudinal mixed methods multiple case study including 13 networks of primary care professionals as cases. Data collection comprised continuously-kept logs; yearly network maturity score (range 0-24), yearly quality of care assessment (quality indicators, 0-100), and in-depth interviews.

RESULTS

Networks consisted of median nine professionals (range 5-22) covering medical, care and welfare disciplines. Their follow-up was 1-2 years. Average yearly increase was 2.03 (95%-CI:1.20-2.96) on network maturity and 8.45 (95%-CI:2.80-14.69) on quality indicator score. High primary care practice involvement and strong leadership proved essential in the transition towards more mature networks with better quality of care.

DISCUSSION

Progress towards more mature networks favored quality of care improvements. DementiaNet appeared to be effective to realize transition towards network-based care, enhance multidisciplinary collaboration, and improve quality of dementia care.

摘要

简介

本研究旨在深入了解 DementiaNet 的优势，这是一种基于网络的社区居住痴呆症患者初级保健创新。

方法

纵向混合方法多案例研究，包括 13 个初级保健专业人员网络作为案例。数据收集包括持续记录；每年的网络成熟度评分（范围 0-24）、每年的护理质量评估（质量指标，0-100）和深入访谈。

结果

网络由中位数为 9 名专业人员（范围 5-22）组成，涵盖医疗、护理和福利学科。他们的随访时间为 1-2 年。网络成熟度的平均年增长率为 2.03（95%-CI：1.20-2.96），质量指标得分的平均年增长率为 8.45（95%-CI：2.80-14.69）。初级保健实践的高度参与和强有力的领导在向更成熟的网络和更好的护理质量过渡方面被证明是至关重要的。

讨论

向更成熟网络的发展有利于改善护理质量。DementiaNet 似乎有效地实现了向基于网络的护理的转变，增强了多学科合作，并提高了痴呆症护理的质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0633/6021091/6f3cfa1e6829/pone.0198811.g007.jpg
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