患者、照护者和医疗保健专业人员在初级保健中对多病症患者进行跨学科干预的体验：一项定性研究。
Patients, caregivers and health-care professionals' experience with an interdisciplinary intervention for people with multimorbidity in primary care: A qualitative study.
机构信息
Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada.
Westmead Applied Research Centre, The University of Sydney, Camperdown, NSW, Australia.
出版信息
Health Expect. 2020 Apr;23(2):318-327. doi: 10.1111/hex.13035. Epub 2020 Feb 8.
BACKGROUND
Multimorbidity challenges the health-care system and requires innovative approaches. In 2015, a 4-month patient-centred interdisciplinary pragmatic intervention was implemented in primary care with the aim of supporting self-management for patients with multimorbidity.
OBJECTIVE
To explore the perceptions and experiences of health-care professionals, patients and their caregivers with a 4-month patient-centred interdisciplinary pragmatic intervention in primary care.
DESIGN
A descriptive, qualitative study using semi-structured interviews was conducted.
SETTING AND PARTICIPANTS
A purposive sample of 30 participants was recruited from seven family medicine groups including patients, caregivers and health-care professionals (HCPs). Interviews were analysed using Thorne's interpretive description approach.
RESULTS
Findings were grouped into the benefits and challenges of participating in the intervention. The programme allowed patients to adopt realistic and adapted objectives; to customize interventions to the patient's reality; and to help patients gain confidence, improve their knowledge, skills and motivation to manage their condition. Interprofessional collaboration eased the exchange of information via team meetings and electronic medical records. Challenges were related to collaboration, communication, coordination of work and integration of newly relocated HCPs mainly due to part-time assignments and staff turnover. HCPs part-time schedules limited their availability and hindered patients' follow-up.
DISCUSSION AND CONCLUSION
This intervention was useful and rewarding from the HCPs, patients and caregivers' perspective. However, to ensure the success of this complex interdisciplinary intervention, implementers and managers should anticipate organizational barriers such as availability and time management of relocated HCPs.
背景
多种疾病给医疗保健系统带来了挑战，需要创新的方法。2015 年，在初级保健中实施了一项为期 4 个月的以患者为中心的跨学科务实干预措施，旨在为患有多种疾病的患者提供自我管理支持。
目的
探讨卫生保健专业人员、患者及其照护者对初级保健中 4 个月以患者为中心的跨学科务实干预措施的看法和体验。
设计
使用半结构式访谈进行描述性定性研究。
设置和参与者
从包括患者、照护者和卫生保健专业人员（HCP）在内的 7 个家庭医学组中，采用目的抽样法招募了 30 名参与者。使用 Thorne 的解释性描述方法对访谈进行分析。
结果
研究结果分为参与干预的益处和挑战。该方案允许患者采用现实和适应的目标；根据患者的实际情况定制干预措施；并帮助患者获得信心，提高他们的知识、技能和管理病情的动机。通过团队会议和电子病历，跨专业协作简化了信息交流。挑战与协作、沟通、工作协调以及新搬迁的 HCP 的整合有关，主要是由于兼职安排和员工流失。HCP 的兼职时间表限制了他们的可用性，并阻碍了患者的随访。
讨论和结论
从 HCP、患者和照护者的角度来看，这种干预措施是有用和有益的。然而，为了确保这种复杂的跨学科干预措施的成功，实施者和管理者应该预见到组织障碍，例如搬迁的 HCP 的可用性和时间管理。
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