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照护者使用参与和环境测量升级版(PEM+)创建以参与为重点的护理计划,PEM+是一种用于以家庭为中心护理的电子健康工具。

Caregiver creation of participation-focused care plans using Participation and Environment Measure Plus (PEM+), an electronic health tool for family-centred care.

作者信息

Bosak Dianna L, Jarvis Jessica M, Khetani Mary A

机构信息

Department of Occupational Therapy, University of Illinois at Chicago, Chicago, Illinois.

Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA.

出版信息

Child Care Health Dev. 2019 Nov;45(6):791-798. doi: 10.1111/cch.12709. Epub 2019 Jul 30.

Abstract

BACKGROUND

Family-centred care (FCC) is a model for rehabilitation practice that focuses on collaborative partnerships between providers and clients (i.e., children and their caregivers). FCC is a best-practice standard and is expected to yield better outcomes for children and greater caregiver satisfaction with rehabilitation services. A commonly cited barrier to implementing FCC is perceptions about caregiver capability to contribute to designing an initial plan of care, due to lack of skill and/or interest.

OBJECTIVES

The aim of this study is to address FCC barriers through three objectives: (a) report the proportion of caregivers that created multiple care plans using PEM+, an electronic health tool, (b) assess the proportion of caregivers that created complete and participation-focused care plan(s) and that exceeded criteria of a complete plan, and (c) describe characteristics of caregivers that did not create a complete care plan.

METHODS

Study objectives were addressed via secondary analyses of a subset of data from the PEM + pilot trial. Participants were caregivers (N = 18) of children with developmental disabilities (aged 0-5 years) receiving rehabilitation services in an early childhood programme. A deductive analytic approach was used to code care plan content to criteria and to determine proportion of caregivers with a complete and participation-focused care plan and those that exceeded the criteria.

RESULTS

Multiple care plans were created by 72% of the caregivers, 83% caregivers created at least one care plan that was complete and participation-focused per criteria, and 83% exceeded the criteria.

CONCLUSION

The high occurrence of caregivers who developed multiple care plans and who developed high-quality care plans, in their completeness and participation-focused features, suggests that caregivers are interested and capable of participating in a collaborative goal setting process when using PEM+. This indicates that FCC is feasible to implement in clinical workflow with the use of an electronic health tool, which may better facilitate such care. PEM+ warrants further efficacy testing prior to implementation.

摘要

背景

以家庭为中心的护理(FCC)是一种康复实践模式,侧重于提供者与服务对象(即儿童及其照顾者)之间的合作关系。FCC是一种最佳实践标准,有望为儿童带来更好的康复效果,并提高照顾者对康复服务的满意度。实施FCC的一个常见障碍是,由于缺乏技能和/或兴趣,人们认为照顾者没有能力参与制定初始护理计划。

目的

本研究旨在通过三个目标解决FCC的障碍:(a)报告使用电子健康工具PEM+制定多个护理计划的照顾者比例;(b)评估制定了完整且以参与为重点的护理计划并超出完整计划标准的照顾者比例;(c)描述未制定完整护理计划的照顾者的特征。

方法

通过对PEM+试点试验的部分数据进行二次分析来实现研究目标。参与者是在一个幼儿项目中接受康复服务的发育障碍儿童(0至5岁)的照顾者(N = 18)。采用演绎分析方法将护理计划内容按照标准进行编码,以确定制定了完整且以参与为重点的护理计划的照顾者比例以及超出标准的照顾者比例。

结果

72%的照顾者制定了多个护理计划,83%的照顾者至少制定了一个符合标准的完整且以参与为重点的护理计划,83%的照顾者超出了标准。

结论

制定多个护理计划以及制定高质量护理计划(在完整性和以参与为重点方面)的照顾者比例很高,这表明照顾者有兴趣且有能力在使用PEM+时参与协作目标设定过程。这表明在临床工作流程中使用电子健康工具来实施FCC是可行的,这可能会更好地促进此类护理。在实施之前,PEM+需要进一步进行疗效测试。

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