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老年人居家康复途径中的患者参与:一项纵向单病例研究。

Patient Involvement During a Pathway of Home-Based Reablement for Older Persons: A Longitudinal Single-Case Study.

作者信息

Ingstad Kari, Moe Aud, Brataas Hildfrid Vikkelsmo

机构信息

Faculty of Nursing and Health Sciences, Nord University, Campus Levanger, Levanger, Norway.

出版信息

J Multidiscip Healthc. 2021 Jul 22;14:1911-1921. doi: 10.2147/JMDH.S321760. eCollection 2021.

Abstract

BACKGROUND

In recent years, home-based reablement has become an increasingly popular way to provide rehabilitation services. This health care service aims to enable older persons to live longer at home while reducing the need for institutionalization. To ensure the provision of high-quality services, there is a continual need for research on issues of user involvement and co-creation during the pathway of the reablement process.

PURPOSE

This study focused on user involvement and participation with health care professionals during the reablement process.

METHODS

This was a longitudinal, instrumental single-case study, in which one 85-year-old female patient was followed over the pathway of a six-week reablement process. Data were collected at three stages, including the goal-mapping phase, evaluation phase, and three weeks after completing reablement.

RESULTS

Our analyses revealed two themes for the goal-mapping phase (dialogue led by the care provider and main goal), three themes for the implementation phase (the home as the preferred setting, little influence on organizational factors, and participation, influence, and motivation), and three themes for the evaluation phase (patient understanding as a precondition, motivated by weak paternalism, and self-determination requires clear communication).

CONCLUSION

The patient becomes involved through a partly co-creation process. During this time, they are involved, motivated, and influenced over the pathway of reablement. Health care providers must avoid implementing too much control during the pathway of home-based reablement, as patients have contextual knowledge that care providers do not possess.

摘要

背景

近年来,居家康复已成为提供康复服务越来越受欢迎的方式。这项医疗服务旨在使老年人能够在家中更长久地生活,同时减少机构养老的需求。为确保提供高质量服务,在康复过程中持续需要研究用户参与和共同创造的问题。

目的

本研究聚焦于康复过程中用户与医疗保健专业人员的参与情况。

方法

这是一项纵向、工具性单案例研究,对一名85岁女性患者在为期六周的康复过程中进行跟踪。在三个阶段收集数据,包括目标规划阶段、评估阶段以及完成康复三周后。

结果

我们的分析揭示了目标规划阶段的两个主题(由护理提供者主导的对话和主要目标)、实施阶段的三个主题(家庭作为首选环境、对组织因素影响较小以及参与、影响和动机)以及评估阶段的三个主题(患者理解作为前提条件、受温和家长作风驱动以及自决需要清晰沟通)。

结论

患者通过部分共同创造过程参与其中。在此期间,他们在康复过程中参与、受到激励并受到影响。医疗保健提供者在居家康复过程中必须避免实施过多控制,因为患者拥有护理提供者所没有的情境知识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e47/8313399/e079097f6db0/JMDH-14-1911-g0001.jpg

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