澳大利亚足病医生对老年人康复的理解和当前实践：一项定性探索性研究。
Australian podiatrists' understanding and current practices of reablement for older people: a qualitative exploratory study.
机构信息
Centre for Ergonomics and Human Factors, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia.
出版信息
J Foot Ankle Res. 2022 Nov 8;15(1):82. doi: 10.1186/s13047-022-00578-9.
BACKGROUND
The ageing of Australia's population is placing significant pressure on health and social aged care services due to increasing demand for the provision and a relative decrease in the healthcare workforce. Reablement has been introduced by the Australian Commonwealth Government and is aimed at increasing older people's independence to age in place and decreasing dependency on aged care services. To date, research on reablement practice has focussed on interventions from physiotherapists, occupational therapists, and nurses, with no data available on podiatrist involvement. The aim of this research was to explore Australian podiatrists' understanding and current practice of implementing a reablement approach to older clients.
METHODS
A qualitative exploratory study was conducted with Australian podiatrists who had experience working with older people and were familiar with the reablement model. Podiatrists were recruited after completing a prior web-based survey. Promotion of the web-based survey was via professional networks and Twitter. Interviews were audio-recorded, transcribed verbatim, and analysed using Braun and Clarke's approach to thematic analysis.
RESULTS
Fourteen podiatrists were interviewed. Using thematic analysis, three themes were generated: (i) Thinking and practicing differently, (ii) Reconciling practice with competing pressures, (ii) Funding influences on podiatry practice and reablement. Rather than identifying practice examples that demonstrate involvement by podiatrists in older peoples reablement, our analysis identified system level barriers which gave negative influence on podiatrists' ability to implement the reablement model.
CONCLUSIONS
The participants in this study considered their role in reablement for older people was limited. While some participants felt unskilled to implement the reablement model, it is factors such as inadequate funding arrangements and clients' perceptions of podiatrists' roles have a more significant impact on current practice and are seemingly more intractable.
背景
由于对提供服务的需求不断增加，以及医疗保健劳动力的相对减少，澳大利亚人口老龄化给健康和社会老年护理服务带来了巨大压力。康复治疗是澳大利亚联邦政府引入的，旨在提高老年人的独立性，让他们能够在自己的家中安享晚年，并减少对老年护理服务的依赖。迄今为止，关于康复治疗实践的研究主要集中在物理治疗师、职业治疗师和护士的干预措施上，而没有关于足病医生参与的数据。本研究的目的是探讨澳大利亚足病医生对为老年客户实施康复治疗方法的理解和当前实践。
方法
采用定性探索性研究方法，对有老年客户工作经验且熟悉康复治疗模式的澳大利亚足病医生进行研究。足病医生是在完成之前的在线调查后被招募的。在线调查的推广是通过专业网络和 Twitter 进行的。访谈进行了录音，并逐字转录，然后使用 Braun 和 Clarke 的主题分析方法进行分析。
结果
对 14 名足病医生进行了访谈。使用主题分析，产生了三个主题：（i）思维和实践方式的转变，（ii）协调实践与竞争压力，（iii）资金对足病实践和康复治疗的影响。我们的分析并没有确定足病医生参与老年人康复治疗的实践示例，而是确定了系统层面的障碍，这些障碍对足病医生实施康复治疗模式的能力产生了负面影响。
结论
本研究的参与者认为他们在老年人康复治疗中的角色有限。虽然一些参与者觉得自己没有技能实施康复治疗模式，但诸如资金安排不足和客户对足病医生角色的看法等因素对当前实践的影响更大，而且似乎更难解决。
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