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社区整合卫生和社会保健服务:对服务使用者及其家属的体验和福利需求的批判性综合评价。

Integrated health and social care in the community: A critical integrative review of the experiences and well-being needs of service users and their families.

机构信息

School of Nursing, Midwifery & Paramedic Practice, Robert Gordon University, Aberdeen, UK.

School Nursing AHSCP & NHSG Strategic Lead CEL 13 School Nursing, NHS Grampian, Aberdeen, UK.

出版信息

Health Soc Care Community. 2021 Jul;29(4):1145-1168. doi: 10.1111/hsc.13179. Epub 2020 Oct 15.

DOI:10.1111/hsc.13179
PMID:33058359
Abstract

A need for people-centred health and social support systems is acknowledged as a global priority. Most nations face challenges in providing safe, effective, timely, affordable, coordinated care around the needs and preferences of people who access integrated health and social care (IHSC) services. Much of the current research in the field focuses on describing and evaluating specific models for delivering IHSC. Fewer studies focus on person-centred experiences, needs and preferences of people who use these services. However, current international guidance for integrated care sets a precedence of person-centred integrated care that meets the health and well-being needs of people who access IHSC services. This integrative literature review synthesises empirical literature from six databases (CINAHL; MEDLINE; AMED; TRIP; Web of Science and Science Direct; 2007-2019). This review aims to better understand the experiences and health and well-being needs of people who use IHSC services in a community setting. Twenty studies met the inclusion criteria and results were thematically analysed. Three overarching themes were identified, including relationships, promoting health and well-being and difficulty understanding systems. Findings of this review indicate that relationships hold significance in IHSC. People who access IHSC services felt that they were not always involved in planning their care and that there was a lack of clarity in navigating integrated systems; subsequently, this impacted upon their experiences of those services. However, service user and informal carer voices appear to be underrepresented in current literature and studies that included their views were found to be of low quality overall. Collectively, these findings support the need for further research that explores the person-centred experiences and needs of people who access IHSC.

摘要

人们认识到,以人为中心的卫生和社会支持系统是全球优先事项。大多数国家在提供安全、有效、及时、负担得起、协调的医疗和社会保健综合服务方面都面临着挑战,以满足使用者的需求和偏好。该领域的大部分当前研究都集中在描述和评估提供综合医疗和社会保健服务的具体模式。关注使用这些服务的人以患者为中心的体验、需求和偏好的研究较少。然而,当前的国际综合保健指南为以人为中心的综合保健设定了一个先例,以满足使用综合保健服务的人的健康和福祉需求。这篇综合文献综述综合了六个数据库(CINAHL、MEDLINE、AMED、TRIP、Web of Science 和 Science Direct;2007-2019 年)的实证文献。本综述旨在更好地了解在社区环境中使用综合医疗和社会保健服务的人的体验和健康与福祉需求。有 20 项研究符合纳入标准,结果进行了主题分析。确定了三个总体主题,包括关系、促进健康和福祉以及难以理解系统。本综述的结果表明,人际关系在综合医疗和社会保健中具有重要意义。使用综合医疗和社会保健服务的人认为,他们并不总是参与自己的护理计划,而且在整合系统方面缺乏明确性;因此,这影响了他们对这些服务的体验。然而,在当前的文献中,服务使用者和非正式照顾者的声音似乎没有得到充分体现,而且发现纳入他们观点的研究总体质量较低。总的来说,这些发现支持进一步研究的需要,以探讨使用综合医疗和社会保健服务的人的以患者为中心的体验和需求。

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