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患有多种疾病的老年初级保健患者及其护理人员在医疗系统中的就医经历:一项定性研究方案。

Experiences of older primary care patients with multimorbidity and their caregivers in navigating the healthcare system: A qualitative study protocol.

作者信息

Lee Eng Sing, Muthulingam Gayathri, Chew Evelyn Ai Ling, Lee Poay Sian Sabrina, Koh Hui Li, Quak Stephanie Xin En, Ding Yew Yoong, Subramaniam Mythily, Vaingankar Janhavi Ajit

机构信息

Clinical Research Unit, National Healthcare Group Polyclinics, Singapore.

Geriatric Education and Research Institute, Khoo Teck Puat Hospital, Singapore.

出版信息

J Comorb. 2020 Dec 29;10:2235042X20984064. doi: 10.1177/2235042X20984064. eCollection 2020 Jan-Dec.

Abstract

BACKGROUND

Patients with multimorbidity must bear not just the burden of their illness, but also the burden of treatment which is, in part, induced by their interactions with the healthcare system. The need to shuttle between different healthcare institutions and multiple healthcare providers can make navigating the healthcare system challenging, and this may be even more so for older patients with limited resources and support.

OBJECTIVES

Few qualitative studies have explored the experiences of patients with multimorbidity in navigating the healthcare system. This study will explore the experiences of older patients with multimorbidity and their caregivers as they navigate through the healthcare system. We aim to arrive at a better understanding of patient experiences of possible gaps in the continuity of care and how the current system can be modified and adapted to better address the needs of older patients with multimorbidity.

METHOD

Semi-structured, in-depth interviews will be conducted with purposively sampled older patients with multimorbidity, aged 60 and above seen in primary care, together with their caregivers. Interviews will be transcribed verbatim and analysed by the study team using inductive thematic analysis.

CONCLUSIONS

Our study seeks to explore the navigational experiences within the healthcare system for older patients with multimorbidity in an Asian, multi-ethnic society. The findings will be shared with decision-makers in the healthcare setting in order to improve patient care for this population and ultimately maximise their positive health outcomes, and will add to better understanding how the burden of treatment arising from navigational challenges within the healthcare system may be reduced for older patients with multimorbidity.

摘要

背景

患有多种疾病的患者不仅要承受疾病的负担,还要承受部分由其与医疗保健系统互动所引发的治疗负担。在不同医疗机构和多位医疗服务提供者之间来回奔波的需求,会使在医疗保健系统中穿梭颇具挑战性,对于资源和支持有限的老年患者而言,情况可能更是如此。

目的

很少有定性研究探讨患有多种疾病的患者在医疗保健系统中的就医经历。本研究将探索患有多种疾病的老年患者及其护理人员在医疗保健系统中的就医经历。我们旨在更好地了解患者对护理连续性中可能存在的差距的体验,以及如何改进和调整当前系统,以更好地满足患有多种疾病的老年患者的需求。

方法

将对在初级保健机构就诊的60岁及以上患有多种疾病的老年患者及其护理人员进行有目的抽样的半结构化深度访谈。访谈将逐字记录,并由研究团队使用归纳主题分析法进行分析。

结论

我们的研究旨在探索在一个亚洲多民族社会中,患有多种疾病的老年患者在医疗保健系统中的就医体验。研究结果将与医疗保健领域的决策者分享,以改善对这一人群的患者护理,最终最大限度地提高他们的积极健康成果,并将有助于更好地理解如何减轻患有多种疾病的老年患者因医疗保健系统中的就医挑战而产生治疗负担。

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