Department of General Practice, Monash University, Melbourne, Vic, Australia.
Australian Institute for Primary Care and Ageing, La Trobe University, Melbourne, Vic, Australia.
J Clin Nurs. 2020 Jul;29(13-14):2317-2328. doi: 10.1111/jocn.15243. Epub 2020 Apr 12.
To explore the healthcare professionals (HCP) experience of providing care coordination to people living with multimorbidity.
There is increasing interest in improving care of people living with multimorbidity who need care coordination to help manage their health. Little is known about the experiences of HCP working with people living with multimorbidity.
Phenomenological approach to understanding the experiences of HCP.
We interviewed 18 HCP, including 11 registered nurses, working in care coordination in Melbourne, Australia. We used interpretative phenomenological analysis to identify themes from descriptions of providing care, identifying and responding to a person's needs, and the barriers and facilitators to providing person-centred care.
We identified four themes as follows: (a) Challenge of focusing on the person; (b) "Hear their story," listening to and giving time to clients to tell their story; (c) Strategies for engagement in the programme; and, (d) "See the bigger picture," looking beyond the disease to the needs of a person. Our results are reported using COREQ.
The HCP experienced challenges to a traditional approach to care when focusing on the person. They described providing care that was person-centred, and acknowledged that optimal, guideline-oriented care might not be achieved. They took the necessary time to hear the story and see the context of the person's life, to help the person manage their health.
For registered nurses in care coordination programmes, focusing on the client may challenge traditional approaches to care. Providing care involves developing a relationship with the client to optimise health outcomes. Experienced registered nurses appear to use skills in reflective practice and accept the parameters of care to improve the client's health and well-being.
探索医疗保健专业人员（HCP）为患有多种疾病的人提供护理协调的经验。
人们越来越关注改善需要护理协调来帮助管理其健康的患有多种疾病的人的护理。对于与患有多种疾病的人一起工作的 HCP 的经验知之甚少。
理解 HCP 经验的现象学方法。
我们采访了 18 名 HCP，包括在澳大利亚墨尔本从事护理协调工作的 11 名注册护士。我们使用解释性现象学分析从提供护理、识别和响应个人需求以及提供以个人为中心的护理的障碍和促进因素的描述中确定主题。
我们确定了以下四个主题：（a）关注个人的挑战；（b）“倾听他们的故事”，倾听并花时间让客户讲述他们的故事；（c）参与该计划的策略；以及，（d）“看到更大的图景”，超越疾病看到个人的需求。我们使用 COREQ 报告结果。
当专注于个人时，HCP 对传统的护理方法提出了挑战。他们描述了以个人为中心的护理，并承认可能无法实现最佳的、基于指南的护理。他们花必要的时间倾听故事并了解个人生活的背景，以帮助个人管理他们的健康。
对于护理协调计划中的注册护士来说，专注于客户可能会挑战传统的护理方法。提供护理涉及与客户建立关系以优化健康结果。经验丰富的注册护士似乎使用反思性实践技能并接受护理参数，以改善客户的健康和福祉。
