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家门口的优质护理:当地医疗专业人员对乡村医院如何为其社区医疗保健做出贡献的看法。

Good care close to home: local health professional perspectives on how a rural hospital can contribute to the healthcare of its community.

作者信息

Blattner Katharina, Stokes Tim, Rogers-Koroheke Marara, Nixon Garry, Dovey Susan M

机构信息

Rural Hospital Medicine and General Practice, Hauora Hokianga, Rawene, Northland; Senior Lecturer, Rural Section, Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, Dunedin.

Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, Dunedin.

出版信息

N Z Med J. 2020 Feb 7;133(1509):39-46.

Abstract

AIM

Hokianga Health in New Zealand's far north is an established health service with a small rural hospital, serving a largely Māori community. The aim of this study was to gain insights into the wider roles of one rural hospital from the perspective of its staff.

METHOD

Eleven face-to-face semi-structured interviews were conducted with employees of Hokianga Health, eight with past and current medical practitioners, three with senior non-medical staff. Interviews were recorded and transcribed. Thematic analysis of the interviews was undertaken using the Framework Method.

RESULTS

Four main themes were identified: 'Our Context', emphasising geographical isolation; 'Continuity of Care', illustrating the role of the hospital across the primary-secondary interface; 'Navigation' of health services within and beyond Hokianga; and the concept of hospital as 'Home'.

CONCLUSION

Findings highlight the importance of geographically appropriate, as well as culturally appropriate, health services. A hospital as part of a rural health service can enhance comprehensive and continuous care for a rural community. Study findings suggest rural hospitals should be viewed and valued as their own distinct entity rather than small-scale versions of larger urban hospitals.

摘要

目的

位于新西兰最北部的霍基昂阿健康服务机构是一家成熟的医疗服务机构,拥有一家小型乡村医院,主要服务毛利族社区。本研究旨在从员工角度深入了解一家乡村医院的更广泛作用。

方法

对霍基昂阿健康服务机构的员工进行了11次面对面的半结构化访谈,其中8次访谈对象为现任和前任医生,3次访谈对象为高级非医疗人员。访谈进行了录音和转录。采用框架法对访谈进行了主题分析。

结果

确定了四个主要主题:“我们的背景”,强调地理隔离;“连续护理”,阐述了医院在初级-二级医疗衔接中的作用;霍基昂阿内外医疗服务的“导航”;以及医院作为“家”的概念。

结论

研究结果凸显了地理位置适宜以及文化适宜的医疗服务的重要性。作为乡村医疗服务一部分的医院可以加强对乡村社区的全面和持续护理。研究结果表明,乡村医院应被视为并珍视其独特的实体,而不是大型城市医院的缩小版。

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