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与体弱老年人和多学科初级保健团队进行镜像会议:过程和影响分析。

Mirror meetings with frail older people and multidisciplinary primary care teams: Process and impact analysis.

机构信息

Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.

Department of Healthy Living, Community Health Service Gelderland-Zuid, Nijmegen, The Netherlands.

出版信息

Health Expect. 2019 Oct;22(5):993-1002. doi: 10.1111/hex.12905. Epub 2019 May 23.

Abstract

OBJECTIVES

To analyse the process and impact of confronting multidisciplinary teams (MTs) in primary care with the experiences of frail older patients through mirror meetings (MMs), with the aim of supporting teams to organize care in a more patient-oriented way.

METHODS

Process and impact analyses were performed using a mixed-method approach. MMs were held with 14 frail older patients and four MTs comprising 23 health-care professionals (HCPs) in primary care in the Netherlands.

RESULTS

Mirror meetings were feasible for frail older people living at home, although their recruitment was time-consuming. Interaction between the patients was scarce, but they valued the opportunity to share their stories. HCPs preferred MMs overwritten reports about patient experiences. An impact analysis revealed four dominant professional areas for improvement: improve alignment with patient goals, improved communication with patients both orally and in writing, developing new pathways to connect with informal caregivers and an increased understanding that most HCPs are relative strangers to their patients.

CONCLUSIONS

Mirror meetings are a relatively simple and promising method for exploring the ways in which frail older patients experience care.

PRACTICE IMPLICATIONS

Given the right conditions, MMs could result in valuable processes to enable MTs to improve their working methods.

摘要

目的

通过镜像会议(MMs)分析初级保健中多学科团队(MTs)面对体弱老年人患者体验的过程和影响,旨在支持团队以更以患者为中心的方式组织护理。

方法

采用混合方法进行过程和影响分析。在荷兰的初级保健中,与 14 名体弱老年人和 4 个由 23 名医疗保健专业人员(HCPs)组成的 MTs 一起进行了 MMs。

结果

MMs 对居住在家中的体弱老年人来说是可行的,尽管他们的招募过程很耗时。患者之间的互动很少,但他们重视分享自己故事的机会。HCPs 更喜欢 MMs 而不是关于患者体验的书面报告。影响分析显示出四个主要的专业改进领域:改善与患者目标的一致性,改善与患者的口头和书面沟通,开发与非正式照顾者联系的新途径,以及更多地理解大多数 HCPs 对他们的患者来说都是相对陌生的。

结论

镜像会议是探索体弱老年人患者护理体验方式的一种相对简单且有前途的方法。

实践意义

在适当的条件下,MMs 可以为 MTs 改进工作方法提供有价值的流程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e937/6803397/22e85e5b2474/HEX-22-993-g001.jpg

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