Hernández-Ascanio José, Perula-de Torres Luis Ángel, Rich-Ruiz Manuel, Roldán-Villalobos Ana María, Perula-de Torres Carlos, Ventura Puertos Pedro Emilio
Universidad de Córdoba; IMIBIC.
Universidad de Córdoba; IMIBIC; Unidad de Medicina de Familia y Comunitaria, Distrito Sanitario de Córdoba.
Aten Primaria. 2022 Feb;54(2):102218. doi: 10.1016/j.aprim.2021.102218. Epub 2021 Dec 1.
To identify the main conditioning factors that Primary Care professionals indicate when implementing and developing interventions on isolation and loneliness.
Qualitative research with grounded theory, systematic analysis and narrative design of topics.
Developed in 12 Primary Care centres of the Health District of Córdoba and Guadalquivir, covering urban and rural areas.
Three profiles were identified: family medicine/community care, community nursing and case management nursing. The selection was carried out among those who showed greater motivation and commitment to an intervention on isolation/loneliness.
Purposive sampling. The work was based on individual in-depth interviews, focus groups and dialogic interviews.
(a) Distorted images persist about loneliness/social isolation and living alone that make it challenging to identify; (b) the main disruptive determinants in the structure and organization of the care system have to do with the absence of screening programs, the hegemony of the biomedical model and the deficit of resources (in light of this model); (c) the main facilitators are linked to the nursing role, privileged for these interventions according to the participants; and, finally, (d) personal components are necessary, both from the older adult and from the professionals.
Intervention on social isolation and loneliness in Primary Care is conditioned by organizational and structural, professional and personal factors. It is essential to take them into account in order to guarantee their feasibility.
确定基层医疗专业人员在实施和开展关于隔离与孤独的干预措施时所指出的主要制约因素。
基于扎根理论、系统分析和主题叙事设计的定性研究。
在科尔多瓦和瓜达尔基维尔河卫生区的12个基层医疗中心开展，涵盖城乡地区。
确定了三类人员：家庭医学/社区护理、社区护理和病例管理护理。在那些对隔离/孤独干预表现出更大积极性和投入度的人员中进行选择。
目的抽样。工作基于个人深度访谈、焦点小组和对话访谈。
（a）关于孤独/社会隔离和独居的扭曲认知仍然存在，这使得识别具有挑战性；（b）护理系统结构和组织中的主要干扰因素与缺乏筛查项目、生物医学模式的主导地位以及（鉴于此模式）资源短缺有关；（c）主要促进因素与护理角色相关，参与者认为这些干预措施中护理角色具有优势；最后，（d）老年人和专业人员的个人因素都是必要的。
基层医疗中对社会隔离和孤独的干预受到组织和结构、专业和个人因素的制约。为保证其可行性，必须考虑这些因素。
