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探索以患者为中心的护理与长期居住护理后生活质量之间的关系:元民族志研究。

Exploring Interrelations Between Person-Centered Care and Quality of Life Following a Transition Into Long-Term Residential Care: A Meta-Ethnography.

机构信息

Institute of Nursing Science, Department of Public Health, University of Basel, Basel, Switzerland.

Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.

出版信息

Gerontologist. 2023 May 9;63(4):660-673. doi: 10.1093/geront/gnac027.

Abstract

BACKGROUND AND OBJECTIVES

Globally, a culture change in long-term residential care (LTRC) moving toward person-centered care (PCC) has occurred in an attempt to improve resident quality of life (QoL). However, a clear understanding of how different aspects contributing to a PCC approach are interrelated with resident QoL is still lacking. This review explores interrelating aspects between PCC and QoL in LTRC using qualitative synthesis.

RESEARCH DESIGN AND METHODS

Ten relevant primary studies were identified from a search of interdisciplinary research databases providing qualitative information. Studies were critically reviewed for key themes and concepts by the research team. We used a meta-ethnography approach to inductively interpret findings across multiple studies and reinterpreted the information using a constructivist approach.

RESULTS

We identified 5 second-order constructs sharing commonalities suggesting interrelations between PCC and QoL: (a) maintaining dignity, autonomy, and independence; (b) knowing the whole person; (c) creating a "homelike" environment; (d) establishing a caring culture; and (e) integrating families and nurturing internal and external relationships. Synthesis translation led to the following third-order constructs: (a) personalizing care within routines, (b) optimizing resident environments, and (c) giving residents a voice.

DISCUSSION AND IMPLICATIONS

There are many interrelating aspects of PCC and QoL following a permanent transition into LTRC, but successful implementation of PCC, which enhances QoL, presents challenges due to organizational routines and constraints. However, by prioritizing resident voices to include their needs and preferences in care, QoL can be supported following a transition into LTRC.

摘要

背景与目的

在全球范围内,长期居住护理(LTRC)机构已经发生了一场文化变革,从以机构为中心的护理(CBC)转向以患者为中心的护理(PCC),试图提高患者的生活质量(QoL)。然而,对于促成 PCC 方法的不同方面如何与患者 QoL 相互关联,我们仍缺乏清晰的认识。本综述使用定性综合的方法来探讨 LTRC 中 PCC 与 QoL 之间的相互关系。

研究设计与方法

从跨学科研究数据库中搜索到 10 项与 PCC 和 QoL 相关的原始研究,这些研究提供了定性信息。研究小组对这些研究进行了关键主题和概念的批判性审查。我们使用元民族志方法对多项研究的结果进行归纳解释,并使用建构主义方法对信息进行重新解释。

结果

我们确定了 5 个具有共同特征的二阶构建体,这些构建体表明 PCC 和 QoL 之间存在相互关系:(a)维护尊严、自主权和独立性;(b)了解整个人;(c)营造“类家庭”环境;(d)建立关爱文化;以及(e)整合家庭并培养内部和外部关系。综合翻译导致以下三阶构建体:(a)在常规护理中个性化护理,(b)优化患者环境,以及(c)赋予患者发言权。

讨论与意义

在长期居住护理机构中,PCC 和 QoL 有许多相互关联的方面,但由于组织惯例和限制,成功实施 PCC 以提高 QoL 存在挑战。然而,通过优先考虑患者的声音,将他们的需求和偏好纳入护理中,可以在进入 LTRC 后支持 QoL。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3981/10167765/3bfde37b770e/gnac027_fig1.jpg

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