Department of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore.
Department of Internal Medicine, Changi General Hospital, Singapore, Singapore.
BMC Med Educ. 2020 May 11;20(1):148. doi: 10.1186/s12909-020-02064-x.
Older persons consume disproportionately more healthcare resources than younger persons. Tri-Generational HomeCare (TriGen), a service-learning program, aims to reduce hospital admission rates amongst older patients with frequent admissions. The authors evaluated the educational and patient outcomes of TriGen.
Teams consisting of healthcare undergraduates and secondary school (SS) students - performed fortnightly home visits to patients over 6 months. Self-administered scales were used to evaluate the educational outcomes in knowledge and attitudes towards the older people and nine domains of soft skills pre- and post-intervention. Patients' reported satisfaction and clinical outcomes were also assessed.
Two hundred twenty-six healthcare undergraduates and 359 SS students participated in the program from 2015 to 2018. Response rates were 80.1 and 62.4% respectively. One hundred six patients participated in TriGen. There was a significant increase in Kogan's Attitudes towards Old People Scale (KOP) scores for healthcare undergraduates and SS students with a mean increase of 12.8 (95%CI: 9.5-16.2, p < 0.001) and 8.3 (95%CI: 6.2-10.3, p < 0.001) respectively. There was a significant increase in Palmore Facts on Aging Quiz (PFAQ) score for SS students but not for healthcare undergraduates. Most volunteers reported that TriGen was beneficial across all nine domains assessed. There was also a significant decrease in hospital admission rates (p = 0.006) and emergency department visits (p = 0.004) during the 6-month period before and after the program. Fifty-one patients answered the patient feedback survey. Of this, more than 80% reported feeling less lonely and happier.
TriGen, a student-initiated, longitudinal, inter-generational service-learning program consisting of SS students and healthcare undergraduates can reduce ageism, develop soft skills, inculcate values amongst SS students and healthcare undergraduates. In addition, TriGen potentially reduces hospital admissions and emergency department visits, and loneliness amongst frequently admitted older patients.
老年人比年轻人消耗更多的医疗保健资源。Tri-Generational HomeCare(TriGen)是一项服务学习计划,旨在降低频繁住院的老年患者的住院率。作者评估了 TriGen 的教育和患者结果。
由医学生和中学生组成的团队——在 6 个月内对患者进行两周一次的家访。使用自我管理量表评估干预前后对老年人的知识和态度以及软技能的九个领域的教育结果。还评估了患者的满意度和临床结果。
2015 年至 2018 年期间,有 226 名医学生和 359 名中学生参加了该计划。响应率分别为 80.1%和 62.4%。有 106 名患者参加了 TriGen。医学生和中学生的 Kogan 老年人态度量表(KOP)评分均有显著增加,平均增加 12.8(95%CI:9.5-16.2,p<0.001)和 8.3(95%CI:6.2-10.3,p<0.001)。中学生的 Palmore 老龄化测验(PFAQ)评分也有显著增加,但医学生没有。大多数志愿者报告说,TriGen 在所有九个评估领域都有益处。在计划前后的 6 个月内,住院率(p=0.006)和急诊科就诊率(p=0.004)均显著下降。51 名患者回答了患者反馈调查。其中,超过 80%的人表示感到不那么孤独和更快乐。
TriGen 是一项由学生发起的、纵向的、代际间的服务学习计划,由中学生和医学生组成,可减少年龄歧视,培养中学生和医学生的软技能,灌输价值观。此外,TriGen 可能会降低频繁住院的老年患者的住院率和急诊科就诊率,以及孤独感。