一种新的社区生活模式的质性评估：医疗寄养安置

A qualitative evaluation of a new community living model: medical foster home placement.

作者信息

Levy Cari R, Jones Jacqueline, Haverhals Leah M, Nowels Carolyn T

机构信息

Denver Veterans Affairs Medical Center and the University of Colorado Denver, Denver, the United States.

College of Nursing, University of Colorado Denver, Denver, the United States.

出版信息

J Nurs Educ Pract. 2013 Sep 5;4(1):162-176. doi: 10.5430/jnep.v4n1p162.

DOI:10.5430/jnep.v4n1p162

PMID:31662814

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6819003/

Abstract

BACKGROUND

The Department of Veterans Affairs (VA) Medical Foster Home (MFH) program is an alternative to nursing home (NH) placement for veterans who are NH-eligible but prefer to receive care in private homes. Program expansion is ongoing; however, inefficiencies exist in targeting Veterans for enrollment.

METHODS

Semi-structured interviews were conducted with 35 individuals, 9 national MFH coordinators, 14 Primary Care Team Members, 2 veterans living in MFHs, 4 of their family members, 3 caregivers, and 3 family members of veterans who declined to participate in the program. Transcripts were analyzed using a general inductive approach supported by Archive for Technology, Lifeworld and Everyday language, text interpretation (ATLAS ti) V6.2.

RESULTS

Three themes were identified as key facilitators of successful MFH placement: 1) The Environment - veterans needed to have appropriate and comfortable physical space that ensured safety and was in a desirable geographic location; 2) The Match - a collaborative relationship between veterans, care providers, and the medical team providing care within the home was essential; and 3) Perceptions and Expectations about the ability for needs to be met in MFHs and challenges related to health concerns, relocation, and costs. These themes, when integrated into the Social Ecological Model, provide a theoretical framework from which to guide future research and understand policy implications.

CONCLUSIONS

MFHs represent a novel alternative to NH placement. This evaluation provides an understanding of factors that lead to successful MFH placement and integrates these themes into a theoretical framework designed to assist both VA policymakers interested in expanding the program and those within the civilian community seeking to study alternatives to traditional NH care.

摘要

背景

美国退伍军人事务部（VA）的医疗寄养家庭（MFH）项目是一种替代方案，为符合疗养院（NH）安置条件但更愿意在私人住宅接受护理的退伍军人提供服务。该项目正在不断扩大；然而，在确定符合条件的退伍军人进行招募方面存在效率低下的问题。

方法

对35人进行了半结构化访谈，其中包括9名全国MFH协调员、14名初级保健团队成员、2名居住在MFH的退伍军人、4名他们的家庭成员、3名护理人员以及3名拒绝参与该项目的退伍军人的家庭成员。使用由技术、生活世界和日常语言存档、文本解释（ATLAS ti）V6.2支持的一般归纳法对访谈记录进行了分析。

结果

确定了三个主题作为成功安置MFH的关键促进因素：1）环境——退伍军人需要有合适且舒适的物理空间，确保安全且地理位置理想；2）匹配——退伍军人、护理提供者以及在家庭中提供护理的医疗团队之间的合作关系至关重要；3）对MFH满足需求能力的认知和期望以及与健康问题、搬迁和成本相关的挑战。这些主题融入社会生态模型后，提供了一个理论框架，可用于指导未来的研究并理解政策含义。