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小事不小:评估富有同情心的社区方法对促进弱势群体健康的作用。

The little things are big: evaluation of a compassionate community approach for promoting the health of vulnerable persons.

机构信息

Faculty of Nursing, University of Windsor, Windsor, Canada.

Department of Family Medicine, McMaster University, Hamilton, Canada.

出版信息

BMC Public Health. 2021 Dec 11;21(1):2253. doi: 10.1186/s12889-021-12256-9.

Abstract

BACKGROUND

Vulnerable persons are individuals whose life situations create or exacerbate vulnerabilities, such as low income, housing insecurity and social isolation. Vulnerable people often receive a patchwork of health and social care services that does not appropriately address their needs. The cost of health and social care services escalate when these individuals live without appropriate supports. Compassionate Communities apply a population health theory of practice wherein citizens are mobilized along with health and social care supports to holistically address the needs of persons experiencing vulnerabilities.

AIM

The purpose of this study was to evaluate the implementation of a compassionate community intervention for vulnerable persons in Windsor Ontario, Canada.

METHODS

This applied qualitative study was informed by the Consolidated Framework for Implementation Research. We collected and analyzed focus group and interview data from 16 program stakeholders: eight program clients, three program coordinators, two case managers from the regional health authority, one administrator from a partnering community program, and two nursing student volunteers in March through June 2018. An iterative analytic process was applied to understand what aspects of the program work where and why.

RESULTS

The findings suggest that the program acts as a safety net that supports people who are falling through the cracks of the formal care system. The 'little things' often had the biggest impact on client well-being and care delivery. The big and little things were achieved through three key processes: taking time, advocating for services and resources, and empowering clients to set personal health goals and make authentic community connections.

CONCLUSION

Compassionate Communities can address the holistic, personalized, and client-centred needs of people experiencing homelessness and/or low income and social isolation. Volunteers are often untapped health and social care capital that can be mobilized to promote the health of vulnerable persons. Student volunteers may benefit from experiencing and responding to the needs of a community's most vulnerable members.

摘要

背景

弱势群体是指其生活状况导致或加剧脆弱性的个人,如低收入、住房不安全和社会孤立。弱势群体经常接受拼凑的医疗和社会保健服务,这些服务无法充分满足他们的需求。当这些人在没有适当支持的情况下生活时,医疗和社会保健服务的成本会上升。关爱社区应用了一种基于人口健康理论的实践,即动员公民和医疗及社会支持一起,全面解决弱势群体的需求。

目的

本研究旨在评估在加拿大安大略省温莎市实施关爱社区干预措施对弱势群体的效果。

方法

本应用定性研究受实施研究综合框架的启发。我们于 2018 年 3 月至 6 月,从 16 名项目利益相关者处收集和分析了焦点小组和访谈数据:8 名项目客户、3 名项目协调员、2 名区域卫生局的个案经理、1 名合作社区项目的管理员,以及 2 名护理专业学生志愿者。应用迭代分析过程,以了解该项目的哪些方面在何处以及为何起作用。

结果

研究结果表明,该计划充当了一个安全网,为那些正在从正式护理系统中滑落的人提供支持。“小事”往往对客户的幸福感和护理服务产生最大影响。这些大事和小事是通过三个关键过程实现的:花时间、倡导服务和资源,以及授权客户设定个人健康目标,并建立真实的社区联系。

结论

关爱社区可以满足无家可归者和/或低收入、社会孤立者的整体、个性化和以客户为中心的需求。志愿者往往是未被挖掘的医疗和社会保健资源,可以动员他们来促进弱势群体的健康。学生志愿者可能受益于体验和响应社区最脆弱成员的需求。

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