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加拿大长期护理环境下老年人的连续性护理:一项定性研究。

Continuity of care for older adults in a Canadian long-term care setting: a qualitative study.

机构信息

Telfer School of Management, University of Ottawa, 55 Laurier Avenue East, Ottawa, ON, K1N 6N5, Canada.

Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Heath, 1 Bridgepoint Drive, Toronto, ON, M4M 2B5, Canada.

出版信息

BMC Health Serv Res. 2022 Sep 27;22(1):1204. doi: 10.1186/s12913-022-08583-1.

Abstract

BACKGROUND

Continuity of care has been shown to improve health outcomes and increase patient satisfaction. Goal-oriented care, a person-centered approach to care, has the potential to positively impact continuity of care. This study sought to examine how a goal-oriented approach impacts continuity of care in a long-term care setting.

METHODS

Using a case study approach, we examined what aspects of goal-oriented care facilitate or inhibit continuity of care from the perspectives of administrators, care providers, and residents in a long-term care centre in Ontario, Canada. Data was collected through documentary evidence and semi-structured interviews.

RESULTS

We analyzed six internal documents (e.g., strategic plan, client information package, staff presentations, evaluation framework, program logic model), and conducted 13 interviews. The findings indicated that the care provided through the goal-oriented approach program had elements that both facilitated and inhibited continuity of care. These factors are outlined according to the three types of continuity, including aspects of the program that influence informational, relational, and management continuity.

CONCLUSIONS

Aspects of the goal-oriented care approach that facilitate continuity can be targeted when designing person-centered care approaches. More research is needed on goal-oriented care approaches that have been implemented in other long-term care settings to determine if the factors identified here as influencing continuity are confirmed.

摘要

背景

已有研究表明,连续性护理可改善健康结局并提高患者满意度。以目标为导向的护理是一种以患者为中心的护理方法,有可能对连续性护理产生积极影响。本研究旨在探讨以目标为导向的护理方法如何在长期护理环境中影响连续性护理。

方法

本研究采用案例研究方法,从加拿大安大略省一家长期护理中心的管理人员、护理提供者和居民的角度,考察以目标为导向的护理方法的哪些方面有利于或不利于连续性护理。通过文献证据和半结构化访谈收集数据。

结果

我们分析了六份内部文件(例如,战略计划、客户信息包、员工演示文稿、评估框架、项目逻辑模型),并进行了 13 次访谈。研究结果表明,通过以目标为导向的方法计划提供的护理具有促进和阻碍连续性护理的因素。根据连续性的三种类型,概述了这些因素,包括影响信息、关系和管理连续性的计划方面。

结论

在设计以患者为中心的护理方法时,可以针对以目标为导向的护理方法中有利于连续性的方面。需要对在其他长期护理环境中实施的以目标为导向的护理方法进行更多研究,以确定这里确定的影响连续性的因素是否得到证实。

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本文引用的文献

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Goal-oriented care for patients with chronic conditions or multimorbidity in primary care: A scoping review and concept analysis.
PLoS One. 2022 Feb 4;17(2):e0262843. doi: 10.1371/journal.pone.0262843. eCollection 2022.
2
Targeting continuity of care and polypharmacy to reduce drug-drug interaction.
Sci Rep. 2020 Dec 4;10(1):21279. doi: 10.1038/s41598-020-78236-y.
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Goal-Oriented Care: A Catalyst for Person-Centred System Integration.
Int J Integr Care. 2020 Nov 4;20(4):8. doi: 10.5334/ijic.5520.
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Health Serv Res. 2021 Jun;56(3):378-388. doi: 10.1111/1475-6773.13541. Epub 2020 Aug 19.
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