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“以行动促沟通”项目的过程评估:一项在家庭护理中实施以人为本沟通的策略

Process evaluation of the ACTION programme: a strategy for implementing person-centred communication in home care.

作者信息

Gustafsson Tanja, Sundler Annelie J, Lindberg Elisabeth, Karlsson Pernilla, Söderholm Hanna Maurin

机构信息

Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Allégatan 1, SE-501 90, Borås, Sweden.

PreHospen Centre for Prehospital Research, University of Borås, Borås, Sweden.

出版信息

BMC Nurs. 2021 Apr 8;20(1):56. doi: 10.1186/s12912-021-00565-8.

Abstract

BACKGROUND

There is currently a strong emphasis on person-centred care (PCC) and communication; however, little research has been conducted on how to implement person-centred communication in home care settings. Therefore, the ACTION (A person-centred CommunicaTION) programme, which is a web-based education programme focusing on person-centred communication developed for nurse assistants (NAs) providing home care for older persons, was implemented. This paper reports on the process evaluation conducted with the aim to describe and evaluate the implementation of the ACTION programme.

METHODS

A descriptive design with a mixed method approach was used. Twenty-seven NAs from two units in Sweden were recruited, and 23 of them were offered the educational intervention. Quantitative and qualitative data were collected from multiple sources before, during and after the implementation. Quantitative data were used to analyse demographics, attendance and participation, while qualitative data were used to evaluate experiences of the implementation and contextual factors influencing the implementation.

RESULTS

The evaluation showed a high degree of NA participation in the first five education modules, and a decrease in the three remaining modules. Overall, the NAs perceived the web format to be easy to use and appreciated the flexibility and accessibility. The content was described as important. Challenges included time constraints; the heavy workload; and a lack of interaction, space and equipment to complete the programme.

CONCLUSIONS

The results suggest that web-based education seems to be an appropriate strategy in home care settings; however, areas for improvement were identified. Our findings show that participants appreciated the web-based learning format in terms of accessibility and flexibility, as well as the face-to-face group discussions. The critical importance of organizational support and available resources are highlighted, such as management involvement and local facilitation. In addition, the findings report on the implementation challenges specific to the dynamic home care context.

TRIAL REGISTRATION

This intervention was implemented with nursing assistants, and the evaluation only involved nursing staff. Patients were not part of this study. According to the ICMJE, registration was not necessary ().

摘要

背景

目前,人们非常强调以患者为中心的护理(PCC)和沟通;然而,关于如何在家庭护理环境中实施以患者为中心的沟通的研究却很少。因此,实施了“行动(以患者为中心的沟通)”计划,这是一个基于网络的教育计划,重点是为为老年人提供家庭护理的护士助理(NA)开展以患者为中心的沟通。本文报告了旨在描述和评估“行动”计划实施情况的过程评估。

方法

采用混合方法的描述性设计。从瑞典两个单位招募了27名护士助理,其中23名接受了教育干预。在实施前、实施期间和实施后从多个来源收集定量和定性数据。定量数据用于分析人口统计学、出勤率和参与情况,而定性数据用于评估实施经验和影响实施的背景因素。

结果

评估显示,护士助理在前五个教育模块中的参与度很高,而在其余三个模块中的参与度有所下降。总体而言,护士助理认为网络形式易于使用,并赞赏其灵活性和可及性。内容被认为很重要。挑战包括时间限制、工作量大以及缺乏完成该计划所需的互动、空间和设备。

结论

结果表明,基于网络的教育似乎是家庭护理环境中的一种合适策略;然而,也确定了需要改进的方面。我们的研究结果表明,参与者赞赏基于网络的学习形式在可及性和灵活性方面的优势,以及面对面的小组讨论。强调了组织支持和可用资源的至关重要性,例如管理层的参与和当地的协助。此外,研究结果报告了动态家庭护理环境特有的实施挑战。

试验注册

本干预措施是针对护士助理实施的,评估仅涉及护理人员。患者未参与本研究。根据国际医学杂志编辑委员会(ICMJE)的规定,无需注册()。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee4b/8034062/cb3c94df35f2/12912_2021_565_Fig1_HTML.jpg

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