Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
BMJ Open. 2021 Mar 18;11(3):e043541. doi: 10.1136/bmjopen-2020-043541.
To explore the experience of infection from the perspective of community-dwelling older people, including access and preferences for place of care.
Qualitative interview study, carried out between March 2017 and August 2018.
Ambulatory care units in Oxfordshire, UK.
Adults >70 years with a clinical diagnosis of infection.
Semistructured interviews based on a flexible topic guide. Participants were given the option to be interviewed with their caregiver. Thematic analysis was facilitated by NVivo V.11.
Participants described encountering several barriers when accessing an urgent healthcare assessment which were hard to negotiate when they felt unwell. They valued home comforts and independence if they received care for their infection at home, though were worried about burdening their family. Most talked about hospital admission being a necessity in the context of more severe illness. Perceived advantages included monitoring, availability of treatments and investigations. However, some recognised that admission put them at risk of a hospital-acquired infection. Ambulatory care was felt to be convenient if local, but daily transport was challenging.
Providers may need to think about protocols and targeted advice that could improve access for older people to urgent healthcare when they feel unwell. General practitioners making decisions about place of care may need to better communicate risks associated with the available options and think about balancing convenience with facilities for care.
从社区居住的老年人的角度探讨感染体验，包括获得护理的途径和对护理场所的偏好。
2017 年 3 月至 2018 年 8 月期间进行的定性访谈研究。
英国牛津郡的门诊护理单位。
患有感染临床诊断的 70 岁以上成年人。
基于灵活主题指南的半结构化访谈。参与者可以选择与他们的照顾者一起接受采访。NVivo V.11 促进了主题分析。
参与者描述了在寻求紧急医疗评估时遇到的几个障碍，如果他们在家中接受感染治疗，这些障碍很难克服。他们重视家庭舒适和独立性，但又担心给家人带来负担。大多数人认为在病情较重的情况下，住院是必要的。认为住院的好处包括监测、治疗和检查的可及性。然而，一些人认识到住院会使他们面临医院获得性感染的风险。如果当地有门诊护理，感觉会很方便，但每天的交通是一个挑战。
当老年人感到不适时，提供者可能需要考虑一些协议和针对性的建议，以改善他们获得紧急医疗服务的途径。做出护理场所决策的全科医生可能需要更好地沟通可用选项相关的风险，并考虑在便利和护理设施之间取得平衡。
