Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Scand J Prim Health Care. 2020 Jun;38(2):132-145. doi: 10.1080/02813432.2020.1755786. Epub 2020 Apr 29.
Comprehensive geriatric assessment (CGA) is recommended for the management of frailty. Little is known about professionals' experiences of CGA; therefore we wanted to investigate the experiences of staff in primary care using a new CGA tool: the Primary care Assessment Tool for Elderly (PASTEL). Focus group interviews. Manifest qualitative content analysis. Nine primary health care centres in Sweden that participated in a CGA intervention. These centres represent urban as well as rural areas. Nine nurses, five GPs and one pharmacist were divided into three focus groups. Participants' experiences of conducting CGA with PASTEL. The analysis resulted in four main categories. : The participants considered the assessment tool to be feasible and valuable. They stated that having enough time for the assessment interview was essential but views about the ideal patient for assessment were divided. : The process of adapting the assessment to the individual and create conditions for dialogue was recognised as important. : In-depth conversations turned out to be an important component of the assessment. Patients were eager to share their stories, but talking about the future or the end of life was demanding. PASTEL was regarded as a good preparation tool for care planning and a means of support for identifying appropriate actions to manage frailty but there were challenges to implement these actions and to obtain good teamwork. The participants reported that PASTEL, a tool for CGA, gave a holistic picture of the older person and was helpful in care planning.Key pointsTo manage frailty using comprehensive geriatric assessment (CGA) in primary care, there is a need for tools that are efficient, user-friendly and which support patient involvement and teamwork•This study found that the Primary care Assessment tool for Elderly (PASTEL) is regarded as both valuable and feasible by primary care professionals•Use of carefully selected items in the tool and allowing enough time for dialogue may enhance patient-centeredness•The PASTEL tool supports the process of identifying actions to manage frailty in older adults. Teamwork related to the tool and CGA in primary care needs to be further investigated and developed.
全面老年评估(CGA)被推荐用于虚弱症的管理。对于专业人员在 CGA 方面的经验,我们知之甚少;因此,我们希望使用一种新的 CGA 工具(初级保健老年评估工具,PASTEL)来调查初级保健人员的经验。焦点小组访谈。显性的定性内容分析。瑞典九家参与 CGA 干预的初级保健中心。这些中心代表了城市和农村地区。九名护士、五名全科医生和一名药剂师分为三组进行焦点小组讨论。参与者使用 PASTEL 进行 CGA 的经验。分析结果得出了四个主要类别。工具的可行性和价值。他们表示,有足够的时间进行评估访谈是至关重要的,但对适合评估的理想患者的看法存在分歧。适应评估以满足个体需求并为对话创造条件被认为是重要的。深入的对话被证明是评估的一个重要组成部分。患者渴望分享他们的故事,但谈论未来或生命的终结是具有挑战性的。PASTEL 被认为是制定护理计划的良好准备工具,也是确定管理虚弱相关行动的支持手段,但在实施这些行动和获得良好的团队合作方面存在挑战。参与者报告说,PASTEL 作为一种 CGA 工具,可以全面了解老年人的情况,有助于护理计划。要点:在初级保健中使用全面老年评估(CGA)来管理虚弱症,需要使用高效、易用的工具,支持患者参与和团队合作。本研究发现,初级保健老年评估工具(PASTEL)被初级保健专业人员认为具有价值和可行性。在工具中精心选择项目并为对话留出足够的时间可以增强以患者为中心的方法。PASTEL 工具支持确定管理老年人虚弱相关行动的过程。需要进一步调查和发展与工具和初级保健 CGA 相关的团队合作。