Kennedy Fiona, Galvin Rose, Horgan N Frances
Meath Primary Care Services, Community Health Organisation (CHO) 8, Health Service Executive (HSE), Ireland.
School of Allied Health, University of Limerick (UL), Ireland.
J Frailty Sarcopenia Falls. 2021 Mar 1;6(1):1-8. doi: 10.22540/JFSF-06-001. eCollection 2021 Mar.
Little is known about the views of key stakeholders on frailty in Primary Care in Ireland. The aim of this study was to explore the views of Irish healthcare professionals and patients on frailty and its management in Primary Care.
A qualitative descriptive design was used. Seventeen healthcare professionals and three patients were recruited using purposive sampling. Data were collected using semi-structured interviews which were analysed thematically.
Three themes were identified: (i) Perceptions of Frailty (ii) Current Management of Frailty and (iii) Comprehensive Geriatric Assessment in Primary Care. The results demonstrated variability in perspectives on frailty. Healthcare professionals described a fragmented service often delivering substandard care to frail older patients. The general consensus was that frailty management required an adequately resourced Primary Care service. Support for frailty screening and Comprehensive Geriatric Assessment was evident while the suitability of the current pathway for patients requiring assessment was questioned.
This study highlights an absence of a shared and complete understanding of frailty among healthcare professionals and a fragmented model of care for community-dwelling frail older patients. Based on these findings, inter-professional training, investment in Primary Care, the development of a frailty pathway and an interface service is recommended.
对于爱尔兰初级保健中关键利益相关者对衰弱的看法，人们了解甚少。本研究的目的是探讨爱尔兰医疗保健专业人员和患者对初级保健中衰弱及其管理的看法。
采用定性描述性设计。通过目的抽样招募了17名医疗保健专业人员和3名患者。使用半结构化访谈收集数据，并进行主题分析。
确定了三个主题：（i）对衰弱的认知（ii）目前对衰弱的管理（iii）初级保健中的综合老年评估。结果表明，对衰弱的看法存在差异。医疗保健专业人员描述了一种碎片化的服务，常常为体弱的老年患者提供不合格的护理。普遍的共识是，衰弱管理需要资源充足的初级保健服务。对衰弱筛查和综合老年评估的支持是明显的，而当前评估途径对需要评估的患者的适用性受到质疑。
本研究强调医疗保健专业人员对衰弱缺乏共同和完整的理解，以及对社区居住的体弱老年患者的碎片化护理模式。基于这些发现，建议进行跨专业培训、对初级保健进行投资、制定衰弱管理途径和建立接口服务。
