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体弱老年人的综合老年评估:理想与现实

Comprehensive geriatric assessment of frail older people: ideals and reality.

作者信息

Ivanoff Synneve Dahlin, Duner Anna, Eklund Kajsa, Wilhelmson Katarina, Lidén Eva, Holmgren Eva

机构信息

Center of Aging and Health-AGECAP, Institute of Neuroscience and Physiology, Section of Health and Rehabilitation, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.

Center of Aging and Health-AGECAP, Department of Social work, University of Gothenburg, Gothenburg, Sweden.

出版信息

J Interprof Care. 2018 Nov;32(6):728-734. doi: 10.1080/13561820.2018.1508130. Epub 2018 Aug 29.

Abstract

We explored different professionals' views on and experiences of comprehensive geriatric assessment (CGA) of frail older people. Forty-six professionals working in hospitals, primary care, or municipal health and social care participated in 10 focus groups. Professional groups comprised of occupational therapists, physiotherapists, nurses, physicians, and social workers. Participants shared an ideal image of how the CGA of frail elderly people should be conducted. Experience-based competence was more often used as an assessment tool than standardized tests. The ideal image contrasted with reality, listening to the needs expressed, with the person's problems, needs, and priorities in the foreground, as described by the categories: a need that can be met; different perspectives on needs; needs can be hidden; and needs assessment is affected by the collaboration around the person, by the context, and by the dialogue. The health and social care professionals' first priority is to make a person-centred tailor-made comprehensive geriatric assessment and not be bound to instruments. Clear guidelines need to be developed, stating which profession assesses what, when and how in order to ensure that person-centred needs are assessed including structures and procedures for how communication and collaboration within the team as well as between the organizations are achieved in order to perform a good person-centred CGA.

摘要

我们探讨了不同专业人员对体弱老年人综合老年评估(CGA)的看法和经验。46名在医院、初级保健机构或市政卫生与社会护理部门工作的专业人员参加了10个焦点小组。专业小组包括职业治疗师、物理治疗师、护士、医生和社会工作者。参与者分享了体弱老年人CGA应如何开展的理想图景。基于经验的能力比标准化测试更常被用作评估工具。理想图景与现实形成对比,正如“可满足的需求”“对需求的不同看法”“需求可能被隐藏”以及“需求评估受到围绕个体的协作、环境和对话的影响”等类别所描述的那样,关注所表达的需求,将个体的问题、需求和优先事项置于突出位置。卫生和社会护理专业人员的首要任务是进行以患者为中心的量身定制的综合老年评估,而不是受限于评估工具。需要制定明确的指南,说明哪个专业在何时以及如何进行何种评估,以确保对以患者为中心的需求进行评估,包括团队内部以及各组织之间实现沟通与协作的结构和程序,以便开展良好的以患者为中心的CGA。

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