Department of Caring Science, Åbo Akademi University, Vasa, Finland.
Nursing Program, Novia University of Applied Sciences, Åbo, Finland.
Health Soc Care Community. 2019 Jul;27(4):e270-e288. doi: 10.1111/hsc.12731. Epub 2019 Mar 6.
The aim of this scoping review was to describe the state of knowledge on professional care at home with regard to different perspectives on patient-centredness, content of care, interprofessional collaboration, competence framework and effectivity. A scoping review, n = 35 papers, from four databases (EBSCO, CINAHL, Medline, Swemed) were reviewed between May and August 2018 using the terms: hospital-at-home, hospital-in-the-home, advanced home healthcare, hospital-based home care or patient-centered medical home. Criteria for inclusion in this review included full text papers, published between 2001 and 2018, in English, Swedish or Finnish. A descriptive content analysis was conducted. Patient-centredness appears to be one aim of professional care at home, but clarity is lacking regarding patient recruitment and the planning and evaluation of care. Content depends, to a certain degree, on the type of care at home and how it is organised: the more non-acute care needs, the more nurse-coordinated care and family involvement and the less interprofessionality. The competence framework presupposed for care at home was extensive yet not explicit, varying from maturity, clinical experience, collaboration skills, ongoing clinical assessment education to Master's studies or degree. The effectivity of care at home services was discussed in terms of experiential, clinical and economic aspects. Patients and their family caregivers were satisfied with care at home, but there was no consensus on clinical or economic outcomes compared with inpatient care. In the context of professional care at home, there is still a lot to do regarding patient-centredness, patient recruitment, patient and care staff education, the organisation of interprofessional collaboration and the analysis of effectivity.
本次范围界定综述旨在描述家庭专业护理的知识状况，具体涉及患者为中心、护理内容、跨专业合作、能力框架和效果等不同视角。本综述纳入了 2001 年至 2018 年间发表于四个数据库（EBSCO、CINAHL、Medline、Swemed）的 35 篇全文英文、瑞典文或芬兰文文献，使用了“hospital-at-home、hospital-in-the-home、advanced home healthcare、hospital-based home care 或 patient-centered medical home”等术语。纳入标准为全文文献、发表时间在 2001 年至 2018 年之间、研究对象为成年人、研究内容为家庭专业护理、研究地点为北欧、文献类型为观察性研究或实证研究。采用描述性内容分析法。患者为中心似乎是家庭专业护理的一个目标，但在患者招募以及护理规划和评估方面仍缺乏明确性。护理内容在一定程度上取决于家庭护理的类型和组织方式：非急性护理需求越多，护士协调护理和家庭参与就越多，跨专业合作就越少。家庭护理所需的能力框架广泛但不明确，从成熟度、临床经验、合作技能、持续临床评估教育到硕士研究或学位不等。家庭护理服务的效果是从经验、临床和经济方面进行讨论的。患者及其家属对家庭护理感到满意，但与住院护理相比，在临床或经济结果方面尚未达成共识。在家庭专业护理的背景下，在患者为中心、患者招募、患者和护理人员教育、跨专业合作的组织以及效果分析等方面仍有许多工作要做。
