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原发性痴呆护理网络中的护理整合:一项纵向混合方法研究。

Care Integration in Primary Dementia Care Networks: A Longitudinal Mixed-Methods Study.

作者信息

Oostra Dorien L, Harmsen Anne, Nieuwboer Minke S, Rikkert Marcel G M Olde, Perry Marieke

机构信息

Radboud university medical center, Radboud Institute for Health Sciences, Department of Geriatric Medicine, Nijmegen, NL.

Radboudumc Alzheimer Center, Radboud university medical center, Nijmegen, NL.

出版信息

Int J Integr Care. 2021 Dec 8;21(4):29. doi: 10.5334/ijic.5675. eCollection 2021 Oct-Dec.

Abstract

INTRODUCTION

Currently, care integration for community-dwelling persons with dementia is poor and knowledge on how to effectively facilitate development of integrated dementia care is lacking. The DementiaNet program aims to overcome this with a focus on interprofessional collaboration. The objective of this study is to investigate how care integration in interprofessional primary dementia care networks matures and to identify factors associated with (un)successfully maturation.

THEORY AND METHODS

A longitudinal mixed-methods study, including 17 primary care networks participating in the DementiaNet study, was performed. Semi-structured interviews based on the Rainbow Model of Integrated Care were conducted at start, at 12- and 24 months. Network maturity scores (range 1-4) were derived from the interviews and qualitative data was used to explain the observed patterns.

RESULTS

Networks consisted on average of 9 professionals (range 4-22) covering medical, care and social disciplines. Network maturity yearly increased with 0.29 (95%-CI: 0.20-0.38). Important factors for improvement included getting to know each other's expertise, having a capable network leader(s), stable network composition and participation of a general practitioner.

CONCLUSIONS

The DementiaNet approach enables a transition towards more mature networks. Identified success factors provide better understanding of how network maturity can be achieved and gives guidance to future care integration strategies.

摘要

引言

目前,针对社区痴呆症患者的护理整合情况较差,且缺乏关于如何有效促进综合痴呆症护理发展的知识。痴呆症网络项目旨在通过专注于跨专业协作来克服这一问题。本研究的目的是调查跨专业初级痴呆症护理网络中的护理整合如何成熟,并确定与(未)成功成熟相关的因素。

理论与方法

进行了一项纵向混合方法研究,包括17个参与痴呆症网络研究的初级护理网络。在开始时、12个月和24个月时,基于综合护理彩虹模型进行了半结构化访谈。网络成熟度得分(范围为1 - 4)来自访谈,定性数据用于解释观察到的模式。

结果

各网络平均由9名专业人员(范围为4 - 22名)组成,涵盖医学、护理和社会学科。网络成熟度每年提高0.29(95%置信区间:0.20 - 0.38)。改善的重要因素包括了解彼此的专业知识、有能力的网络领导者、稳定的网络组成以及全科医生的参与。

结论

痴呆症网络方法能够实现向更成熟网络的转变。确定的成功因素有助于更好地理解如何实现网络成熟,并为未来的护理整合策略提供指导。

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