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在为智障人士服务的机构中实施和维持姑息治疗创新:一种多方法评估。

Implementation and sustainment of palliative care innovations within organizations for people with intellectual disabilities: A multi-method evaluation.

机构信息

Netherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands.

Netherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Expertise Centre for Palliative Care, Amsterdam, the Netherlands.

出版信息

Disabil Health J. 2021 Apr;14(2):101049. doi: 10.1016/j.dhjo.2020.101049. Epub 2020 Dec 8.

Abstract

BACKGROUND

Providing palliative care for people with intellectual disabilities (ID) is challenging and professionals caring for people with ID often received limited training in palliative care.

OBJECTIVE

To gain insight into the implementation and sustainment of palliative care innovations, originally developed for the general palliative care population, in organizations for people with ID.

METHODS

A multi-method evaluation was performed of nine implementation projects concerning three palliative care innovations. Methods included document analyses of project proposals and reports, group interviews with project managers and professionals, and a questionnaire completed by projects managers. Factors influencing implementation were categorized using the Consolidated Framework for Implementation Research.

RESULTS

The three innovations were applicable in organizations for people with ID, although some adaptations had been made. Implementation activities were focussed on training, cooperation and dissemination of the innovation. Influencing factors were mostly related to the inner setting of the organization, including management support and available resources. Five of the nine project managers were not sure if the innovation was sustained properly within their organization.

CONCLUSIONS

Innovations originally developed for use in the general palliative care population can be successfully implemented in organizations for people with ID, although adaptation to the specific care setting might be necessary.

摘要

背景

为智力残疾(ID)人群提供姑息治疗具有挑战性,而照顾 ID 人群的专业人员通常在姑息治疗方面接受的培训有限。

目的

深入了解最初为一般姑息治疗人群开发的姑息治疗创新在 ID 人群组织中的实施和维持情况。

方法

对涉及三种姑息治疗创新的九个实施项目进行了多方法评估。方法包括对项目提案和报告的文件分析、与项目经理和专业人员的小组访谈,以及项目经理完成的问卷调查。使用实施研究综合框架对影响实施的因素进行了分类。

结果

这三种创新在 ID 人群组织中是适用的,尽管已经进行了一些调整。实施活动侧重于培训、合作和创新的传播。影响因素主要与组织的内部环境有关,包括管理支持和可用资源。九个项目经理中有五个不确定他们组织内的创新是否得到了妥善维持。

结论

最初为一般姑息治疗人群开发的创新可以成功地在 ID 人群组织中实施,尽管可能需要针对特定的护理环境进行调整。

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