为患有多种慢性疾病的人提供以患者为中心的护理：一项纳入患者和工作人员观点的定性研究方案。
Providing person-centred care for people with multiple chronic conditions: protocol for a qualitative study incorporating client and staff perspectives.
机构信息
Department of General Practice, Monash University, Notting Hill, Victoria, Australia
Australian Institute for Primary Care and Aging, La Trobe University, Bundoora, Victoria, Australia.
出版信息
BMJ Open. 2019 Oct 7;9(10):e030581. doi: 10.1136/bmjopen-2019-030581.
INTRODUCTION
Chronic conditions are associated with over one-third of potentially avoidable hospitalisations. Integrated care programmes aim to help people with chronic conditions to self-manage their health, thus avoiding hospital admissions. While founded on principles of person-centred care, the experiences of people with multiple chronic conditions in integrated care programmes are not widely known. Our study will explore how person-centred care is incorporated into an integrated care programme for people with multiple chronic conditions.
METHODS AND ANALYSIS
This is a qualitative phenomenological study being conducted from March 2018 to June 2019, in a large metropolitan health service in Melbourne, Australia. Participants will be programme clients (and/or their carers) and staff working in the programme. We will interview staff about their experiences of the programme. Recruited staff will assist with recruitment of clients who recently completed an episode of care, to participate in a semistructured interview in their home. We will also analyse the medical records of interviewed clients, and observe outpatient clinics connected to the programme, based on the findings of the interviews. We will analyse all data using thematic analysis, with overarching themes representing staff and client perspectives of person-centred care.
ETHICS AND DISSEMINATION
Ethical approval was granted by Monash Health (HREC/18/MonH/33) and Monash University (12260) Human Research Ethics Committees. Our study will provide a comprehensive exploration of person-centred care in an integrated care programme. It will add information to person-centred care literature on participants' perceptions of what works and why, including barriers and enablers to person-centred care in a complex environment. Findings of this study will be disseminated via publications, conferences and presentations to the health service participants.
简介
慢性疾病与超过三分之一的可避免住院治疗有关。综合护理计划旨在帮助慢性病患者自我管理健康，从而避免住院。虽然综合护理计划是以以人为本的护理原则为基础，但患有多种慢性疾病的患者在综合护理计划中的体验并不广为人知。我们的研究将探讨以人为本的护理原则如何融入到针对多种慢性疾病患者的综合护理计划中。
方法与分析
这是一项定性现象学研究，于 2018 年 3 月至 2019 年 6 月在澳大利亚墨尔本的一家大型大都市医疗服务机构进行。参与者将是计划客户（和/或其照顾者）以及在该计划中工作的员工。我们将采访员工，了解他们对该计划的体验。招募的员工将协助招募最近完成护理期的客户，以便在家中进行半结构化访谈。我们还将根据访谈结果分析被访客户的医疗记录，并观察与该计划相关的门诊诊所。我们将使用主题分析对所有数据进行分析，总体主题代表员工和客户对以人为本的护理的看法。
伦理与传播
莫纳什健康（HREC/18/MonH/33）和莫纳什大学（12260）人类研究伦理委员会批准了这项伦理。我们的研究将全面探讨综合护理计划中的以人为本的护理。它将提供以人为本的护理文献中的信息，包括参与者对有效因素和阻碍因素的看法，包括在复杂环境中以人为本的护理的障碍和促进因素。这项研究的结果将通过出版物、会议和演讲传播给参与医疗服务的人员。
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