Hohenberg Mark I, Metri Najwa-Joelle, Firdaus Rubab, Simmons David, Steiner Genevieve Z
School of Medicine, Western Sydney University, Penrith, NSW, 2751, Australia.
NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
BMC Geriatr. 2021 Oct 25;21(1):597. doi: 10.1186/s12877-021-02553-8.
The aim of this study was to inform the development of a Community Geriatrics Service (CGS) that addressed the healthcare and social needs of community dwelling older people in an Australian context.
Stakeholders (N = 108) took part in a 'needs assessment' involving 30-min semi-structured interviews with general practitioners (GPs; N = 49), and three 2-h focus groups (community engagement meetings; N = 59) with older people, informal caregivers, allied healthcare workers, and nursing home directors. Data were transcribed and thematically coded, mapped to source and weighted to the frequency that the theme was raised across sources.
Five themes informing CGS development and delivery emerged: active health conditions (management of behavioural and psychological symptoms of dementia, falls, multimorbidity, and other relevant conditions), active social challenges (patient non-compliance, need for aged care social workers, caregiver stress, elder abuse, social isolation, and stigma), referrals (availability of specialists, communication, specialist input, and advance care directives), access (lack of transport options, and inaccessibility of local geriatrics clinics and specialists), and awareness (lack of awareness, knowledge, and resources).
The CGS will need to address access, referral processes and health system navigation, which were perceived by stakeholders as significant challenges. These findings warrant the development of a CGS with an integrated approach to aged care, pertinent for the health and social needs of the elderly.
本研究旨在为社区老年医学服务（CGS）的发展提供信息，该服务旨在满足澳大利亚社区居住老年人的医疗保健和社会需求。
利益相关者（N = 108）参与了一项“需求评估”，包括与全科医生（N = 49）进行30分钟的半结构化访谈，以及与老年人、非正式护理人员、专职医护人员和养老院院长进行三次2小时的焦点小组讨论（社区参与会议；N = 59）。数据被转录并进行主题编码，映射到来源并根据该主题在各来源中出现的频率进行加权。
出现了五个为CGS发展和提供提供信息的主题：活跃健康状况（痴呆症的行为和心理症状、跌倒、多种疾病及其他相关状况的管理）、活跃社会挑战（患者不依从、老年护理社会工作者的需求、照顾者压力、虐待老年人、社会隔离和耻辱感）、转诊（专科医生的可及性、沟通、专科医生的投入和预先护理计划）、就医机会（缺乏交通选择，以及当地老年医学诊所和专科医生难以到达）和认知（缺乏认知、知识和资源）。
CGS将需要解决就医机会、转诊流程和卫生系统导航问题，利益相关者认为这些是重大挑战。这些发现为开发一种综合老年护理方法的CGS提供了依据，该方法与老年人的健康和社会需求相关。
