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初级保健专业人员在识别和管理虚弱方面的认知、态度和培训需求:一项定性研究。

Perceptions, attitudes and training needs of primary healthcare professionals in identifying and managing frailty: a qualitative study.

机构信息

Department of Primary Care and Population Health, University College London, Rowland Hill Street, London, NW3 2PF, UK.

Université de Lorraine, CHRU-Nancy, Pôle "Maladies du Vieillissement, Gérontologie et Soins Palliatifs", 54000, Nancy, France.

出版信息

Eur Geriatr Med. 2021 Apr;12(2):321-332. doi: 10.1007/s41999-020-00420-0. Epub 2020 Oct 30.

Abstract

PURPOSE

Although frailty can be delayed or prevented by appropriate interventions, these are often not available in countries lacking formal education and infrastructure in geriatrics. The aim of this study was to: (a) explore ideas, perceptions and attitudes of primary health care (PHC) professionals towards frailty in a country where geriatrics is not recognised as a specialty; (b) explore PHC professionals' training needs in frailty; and (c) define components of a frailty educational programme in PHC.

METHODS

Qualitative design, using two focus groups with PHC professionals conducted in Thessaloniki, Greece. Focus groups were audio recorded and transcribed. Data were analysed with thematic analysis.

RESULTS

In total 31 PHC professionals (mean age: 46 years; gender distribution: 27 females, 4 males) participated in the study (physicians n = 17; nurses n = 12; health visitors n = 2). Four main themes were identified: (1) Perceptions and understanding of frailty; (2) Facilitators and barriers to frailty identification and management; (3) Motivation to participate in a frailty training programme; (4) Education and training. The main barriers for the identification and management of frailty were associated with the healthcare system, including duration of appointments, a focus on prescribing, and problems with staffing of allied health professionals, but also a lack of education. Training opportunities were scarce and entirely based on personal incentive. Professionals were receptive to training either face-to-face or online. A focus on learning practical skills was key.

CONCLUSION

Education and training of professionals and interdisciplinary collaboration are essential and much needed for the delivery of person-centred care for people with frailty living in the community.

摘要

目的

尽管适当的干预措施可以延缓或预防衰弱,但在缺乏老年医学正规教育和基础设施的国家,这些干预措施往往无法实施。本研究的目的是:(a) 探讨初级保健(PHC)专业人员在一个不承认老年医学为专业的国家对衰弱的看法、观念和态度;(b) 探讨 PHC 专业人员在衰弱方面的培训需求;(c) 确定 PHC 中衰弱教育计划的组成部分。

方法

使用在希腊塞萨洛尼基进行的两个 PHC 专业人员焦点小组进行定性设计。对焦点小组进行了录音和转录。使用主题分析对数据进行分析。

结果

共有 31 名 PHC 专业人员(平均年龄:46 岁;性别分布:27 名女性,4 名男性)参加了研究(医生 n=17;护士 n=12;健康访视员 n=2)。确定了四个主要主题:(1)对衰弱的看法和理解;(2)识别和管理衰弱的促进因素和障碍;(3)参加衰弱培训计划的动机;(4)教育和培训。识别和管理衰弱的主要障碍与医疗保健系统有关,包括预约时间、专注于开处方以及与医疗保健相关专业人员的人员配备问题,但也缺乏教育。培训机会很少,完全基于个人激励。专业人员对面对面或在线培训都持接受态度。关注学习实用技能是关键。

结论

为了为社区中衰弱的人提供以人为本的护理,对专业人员进行教育和培训以及跨学科合作是必不可少且非常需要的。

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