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全科医生参与专业姑息性居家护理:德国的一项混合方法研究。

GPs' involvement in specialised palliative home care: A mixed methods study in Germany.

机构信息

University of Cologne, Faculty of Human Sciences & Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Cologne, Germany.

Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany.

出版信息

Eur J Gen Pract. 2022 Dec;28(1):224-233. doi: 10.1080/13814788.2022.2139824.

Abstract

BACKGROUND

General practitioners (GPs) are important providers of palliative home care (PHC). To deliver adequate palliative care, cooperation with specialised PHC teams is necessary. Specialised PHC is a type of care for severely ill patients by specialised providers. Little is known about the involvement of German GPs in specialised PHC.

OBJECTIVES

To analyse GPs' experience with realised and desired involvement in specialised PHC. Realised involvement means GPs took part in specialised PHC patients' care. Desired involvement is GPs' hoped-for cooperation with specialised PHC teams: GPs could state whether they want to stay involved, be informed, or provide medical services themselves after referral to specialised PHC.

METHODS

Mixed methods design (focus group with 6 GPs; survey of 445 GPs in North Rhine, Germany, about their experiences in PHC/specialised PHC): Qualitative data was interpreted using content analysis. The authors developed a questionnaire and performed descriptive analysis based on qualitative results.

RESULTS

GPs are mostly satisfied with specialised PHC teams' care, although they report cooperation is not always optimal. GPs describe a high satisfaction with quality of care by specialised PHC teams. However, physicians with higher PC knowledge are less satisfied with specialised PHC. Also, GPs are often less involved in specialised PHC than they wish, especially when they have a higher PC qualification.

CONCLUSION

In general, GPs are satisfied with the quality of care provided by specialised PHC teams but GPs do not always perceive cooperation as optimal. Involvement of GPs in specialised PHC needs to be improved.

摘要

背景

全科医生(GP)是提供姑息治疗居家护理(PHC)的重要提供者。为了提供充分的姑息治疗,与专门的 PHC 团队合作是必要的。专门的 PHC 是由专门提供者为重病患者提供的一种护理。关于德国全科医生参与专门的 PHC 的情况知之甚少。

目的

分析全科医生在专门的 PHC 中的实际参与和期望参与的经验。实际参与是指全科医生参与了专门的 PHC 患者的护理。期望参与是指全科医生希望与专门的 PHC 团队合作:全科医生可以表示他们希望继续参与、获得信息,或在转介到专门的 PHC 后自行提供医疗服务。

方法

混合方法设计(6 名全科医生的焦点小组;对德国北莱茵-威斯特法伦州的 445 名全科医生进行调查,了解他们在 PHC/专门的 PHC 中的经验):使用内容分析法解释定性数据。作者根据定性结果开发了一份问卷,并进行了描述性分析。

结果

全科医生对专门的 PHC 团队的护理大多感到满意,尽管他们报告合作并非总是最佳。全科医生描述了对专门的 PHC 团队提供的护理质量的高度满意度。然而,具有更高 PC 知识的医生对专门的 PHC 的满意度较低。此外,全科医生参与专门的 PHC 的程度往往低于他们的期望,特别是当他们具有更高的 PC 资格时。

结论

总体而言,全科医生对专门的 PHC 团队提供的护理质量感到满意,但他们并不总是认为合作是最佳的。需要改进全科医生参与专门的 PHC 的程度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca0a/9665080/1bc50fed51c5/IGEN_A_2139824_F0001_C.jpg

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