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提升老年人综合照护中的以人为本:欧洲13个综合照护场所的经验

Improving Person-Centredness in Integrated Care for Older People: Experiences from Thirteen Integrated Care Sites in Europe.

作者信息

Stoop Annerieke, Lette Manon, Ambugo Eliva A, Gadsby Erica Wirrmann, Goodwin Nick, MacInnes Julie, Minkman Mirella, Wistow Gerald, Zonneveld Nick, Nijpels Giel, Baan Caroline A, de Bruin Simone R

机构信息

National Institute for Public Health and the Environment, Bilthoven, NL.

Amsterdam Public Health research institute, Amsterdam UMC - VU University Amsterdam, Amsterdam, NL.

出版信息

Int J Integr Care. 2020 Jun 26;20(2):16. doi: 10.5334/ijic.5427.

Abstract

INTRODUCTION

Although person-centredness is a key principle of integrated care, successfully embedding and improving person-centred care for older people remains a challenge. In the context of a cross-European project on integrated care for older people living at home, the objective of this paper is to provide insight at an overarching level, into activities aimed at improving person-centredness within the participating integrated care sites. The paper describes experiences with these activities from the service providers' and service users' perspectives.

METHODS

A multiple embedded case study design was conducted that included thirteen integrated care sites for older people living at home.

RESULTS

Service providers were positive about the activities that aimed to promote person-centred care and thought that most activities (e.g. comprehensive needs assessment) positively influenced person-centredness. Experiences of service users were mixed. For some activities (e.g. enablement services), discrepancies were identified between the views of service providers and those of service users.

DISCUSSION AND CONCLUSION

Evaluating activities aimed at promoting person-centredness from both the service providers' and service users' perspectives showed that not all efforts were successful or had the intended consequences for older people. Involvement of older people in designing improvement activities could ensure that care and support reflect their needs and preferences, and build positive experiences of care and support.

摘要

引言

尽管以患者为中心是综合护理的关键原则,但成功将以患者为中心的护理理念融入并改善老年人护理服务仍是一项挑战。在一个关于居家老年人综合护理的泛欧项目背景下,本文旨在从总体层面深入探讨参与项目的综合护理机构中旨在提升以患者为中心程度的各项活动。本文从服务提供者和服务使用者的角度描述了这些活动的经验。

方法

采用多重嵌入式案例研究设计,涵盖了13个为居家老年人提供服务的综合护理机构。

结果

服务提供者对旨在促进以患者为中心护理的活动持积极态度,并认为大多数活动(如全面需求评估)对以患者为中心程度产生了积极影响。服务使用者的体验则喜忧参半。对于某些活动(如赋能服务),服务提供者和服务使用者的观点存在差异。

讨论与结论

从服务提供者和服务使用者两个角度评估旨在促进以患者为中心的活动表明,并非所有努力都取得了成功,也并非所有努力都对老年人产生了预期效果。让老年人参与改进活动的设计可以确保护理和支持反映他们的需求和偏好,并营造积极的护理和支持体验。

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