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新冠疫情防控措施对新加坡老年患者社区出院计划及综合护理连续性的影响

Impact of COVID-19 Measures on Discharge Planning and Continuity of Integrated Care in the Community for Older Patients in Singapore.

作者信息

Yoon Sungwon, Mo Jiahui, Lim Zhui Ying, Lu Si Yinn, Low Sher Guan, Xu Bangyu, Loo Yu Xian, Koh Chee Wai, Kong Lai Yee, Towle Rachel Marie, Lim Su Fee, Tan Chuen Seng, Kwan Yu Heng, Low Lian Leng

机构信息

Health Services and Systems Research, Duke-NUS Medical School, Singapore.

Centre for Population Health Research and Implementation, SingHealth Regional Health System, Singapore.

出版信息

Int J Integr Care. 2022 May 13;22(2):13. doi: 10.5334/ijic.6416. eCollection 2022 Apr-Jun.

Abstract

INTRODUCTION

The COVID-19 pandemic affects the process of care transition for patients with underlying chronic conditions. This study aims to explore the impact of the pandemic measures on discharge planning and continuum of care for vulnerable older patients from multi-stakeholder perspectives.

METHODS

We conducted focus group discussions and individual interviews with healthcare workers, community partners, government officials and family caregivers in Singapore. All interviews were audio-recorded, transcribed verbatim and thematically analysed.

RESULTS

A total of 53 individuals participated in the study. Discharge planning and care continuity in the community were affected primarily by the limited step-down care options and remote assessment of discharge needs. Participants felt a need to revisit the decision of 'essential' community services through engagement of all stakeholders to enhance care community.To improve better care transition, participants suggested the need for clearer communication of guidelines, improved intersectoral collaboration, shared responsibility of patient care through community engagement and employment of novel models of care.

CONCLUSION

The pandemic measures generated challenges of safe discharge of patients and care continuity in the community. Findings shed light on the need to proactively assess care pathways and catalyse novel models to improve care transition beyond the pandemic.

摘要

引言

新冠疫情影响了患有基础慢性病患者的护理过渡过程。本研究旨在从多利益相关方的角度探讨疫情防控措施对弱势老年患者出院计划及连续护理的影响。

方法

我们在新加坡对医护人员、社区合作伙伴、政府官员和家庭护理人员进行了焦点小组讨论和个人访谈。所有访谈均进行了录音,逐字转录并进行了主题分析。

结果

共有53人参与了该研究。社区中的出院计划和护理连续性主要受到降级护理选择有限以及出院需求远程评估的影响。参与者认为有必要通过所有利益相关方的参与来重新审视“基本”社区服务的决策,以加强护理社区。为了实现更好的护理过渡,参与者建议需要更清晰地传达指导方针,改善部门间协作,通过社区参与分担患者护理责任,并采用新型护理模式。

结论

疫情防控措施给患者安全出院和社区护理连续性带来了挑战。研究结果表明,有必要积极评估护理途径,并推动新型模式以改善疫情之后的护理过渡。

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