专业人员对养老院基于知识的姑息治疗转变的准备情况：教育干预后的定性随访研究。
Professionals´ readiness for change to knowledge-based palliative care at nursing homes: a qualitative follow-up study after an educational intervention.
机构信息
Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, 221 00, Lund, SE, Sweden.
出版信息
BMC Palliat Care. 2022 Jul 20;21(1):132. doi: 10.1186/s12904-022-01018-y.
BACKGROUND
There has been a global increase in the number of people who are dying of old age. This development implies a need for good palliative care among older persons at the end of life. Here nursing homes have an important role to play. However, the principles of palliative care have not been sufficiently applied in nursing homes, and there is a need to increase the implementation of palliative care in these settings. Therefore the project named Implementation of Knowledge-Based Palliative Care in Nursing Homes (the KUPA project, to use its Swedish acronym) was started as a contribution to filling this knowledge gap. The aim of the present study was to investigate the professionals' experiences of readiness for change to knowledge-based palliative care at nursing homes after the educational intervention within the KUPA project.
METHODS
The focus group method was used to interview 39 health-care professionals with the aid of semistructured questions based on the Organizational Readiness for Change theoretical framework. Six focus groups were formed at six nursing homes in two counties in southern Sweden. The groups included different types of professionals: assistant nurses, nurses, occupational therapists, physiotherapists and social workers. The analysis was conducted with an abductive approach and included deductive and inductive content analysis.
RESULTS
The analysis revealed one overarching theme: hopeful readiness for change in palliative care despite remaining barriers. The main categories were increased knowledge facilitating development, enhanced team spirit, uncertainty about future plans connected with hopeful readiness and remaining organizational barriers.
CONCLUSIONS
This study adds knowledge and understanding concerning professionals' readiness for change palliative care in nursing homes and shows how ready nursing home settings undertake these changes in practice. The Organizational Readiness for Change theory proved suitable for application in nursing homes to assess the professionals' experiences and to evaluate educational interventions regardless of the organization's readiness for change.
TRIAL REGISTRATION
ClinicalTrials NCT02708498 , first registration 15/03/2016.
背景
全球范围内，因年老而死亡的人数不断增加。这种发展趋势意味着，临终老年人需要良好的姑息治疗。在这种情况下，养老院扮演着重要的角色。然而，姑息治疗原则在养老院并未得到充分实施，因此需要在这些环境中增加姑息治疗的实施。正因如此，“瑞典知识为本的姑息治疗在养老院的实施（KUPA 项目）”应运而生，旨在填补这一知识空白。本研究旨在调查在 KUPA 项目的教育干预后，养老院专业人员对知识为本的姑息治疗改变的准备情况。
方法
使用焦点小组方法，借助基于组织变革准备理论框架的半结构化问题，对来自瑞典南部两个县的 39 名医护专业人员进行了访谈。在 6 家养老院组建了 6 个焦点小组，小组包含了不同类型的专业人员：助理护士、护士、职业治疗师、物理治疗师和社会工作者。分析采用了归纳推理法，包括演绎和归纳内容分析。
结果
分析揭示了一个总主题：对姑息治疗变革持有的充满希望的准备态度，尽管仍存在障碍。主要类别包括促进发展的知识增长、增强的团队精神、与充满希望的准备相关的未来计划的不确定性以及仍存在的组织障碍。
结论
本研究增加了对养老院姑息治疗变革准备情况的了解和认识，并展示了养老院环境在实践中是如何接受这些变革的。组织变革准备理论被证明适用于评估专业人员的经验和评估教育干预，而无论组织变革的准备情况如何。
试验注册
ClinicalTrials NCT02708498，首次注册日期 2016 年 3 月 15 日。
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