Averlant Lorette, Calafiore Mathieu, Puisieux François, Ramez Claire, Sarrazin Fanny, Lotin Maxime, Naessens Romain, Delesalle Apolline, Adotey Gracia, Harduin Pascal, Leveque Nathalie, Dambre Delphine, Defebvre Marguerite-Marie, Di Martino Carla, Beuscart Jean-Baptiste
Univ. Lille, CHU Lille, METRICS - ULR 2694: Evaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France.
Department of General Medicine, Lille School of Medicine, Lille, France.
Int J Integr Care. 2021 Apr 22;21(2):7. doi: 10.5334/ijic.5483.
Integrated care is a particularly promising approach in geriatrics - a field in which the medical, psychological and social issues are often complex. The uptake of integrated care by healthcare professionals (HCPs) is essential but varies markedly. The objective of the present study of healthcare professionals was to identify barriers to and facilitators of commitment to integrated care for seniors.
We performed a two-step, qualitative study, comprising (i) six qualitative, semi-directive series of interviews with HCPs (hospital practitioners, family physicians, nurses and pharmacists) who agreed or disagreed to take part in the French national "Health Pathway of Seniors for Preserved Autonomy" (PAERPA) pilot program; and (ii) an analysis of the pooled results, in order to identify common concerns among the healthcare professionals.
We identified four key "barrier" and "facilitator" topics shared by HCPs who had committed to the pilot program and those who had not: (i) awareness of and/or interest in geriatric medicine and team working, (ii) the presence of a care coordinator; (iii) the provision of information about the program and about the patient, and communication between HCPs, and (iv) personal benefits for the HCPs and the patients.
The four key topics identified in this large qualitative study of several healthcare professions should be considered during the design and dissemination of integrated care pathways for older patients.
综合照护在老年医学领域是一种特别有前景的方法——在这个领域，医学、心理和社会问题往往很复杂。医疗保健专业人员（HCPs）采用综合照护至关重要，但差异显著。本项针对医疗保健专业人员的研究目的是确定老年综合照护实施过程中的障碍和促进因素。
我们开展了一项分两步进行的定性研究，包括：（i）对同意或不同意参与法国国家“老年人自主生活健康路径”（PAERPA）试点项目的医疗保健专业人员（医院从业者、家庭医生、护士和药剂师）进行六组定性、半指导性系列访谈；（ii）对汇总结果进行分析，以确定医疗保健专业人员中的共同关注点。
我们确定了参与试点项目和未参与试点项目的医疗保健专业人员共同关注的四个关键“障碍”和“促进因素”主题：（i）对老年医学和团队协作的认识和/或兴趣；（ii）护理协调员的存在；（iii）提供有关项目和患者的信息以及医疗保健专业人员之间的沟通；（iv）医疗保健专业人员和患者的个人利益。
在为老年患者设计和推广综合照护路径时，应考虑在这项涉及多个医疗行业的大型定性研究中确定的四个关键主题。
