School of nursing, Shanxi Medical University, Taiyuan City, Shanxi Province, China.
Hangzhou Normal Unviersity, Hangzhou, Zhejiang Province, China.
BMC Health Serv Res. 2023 Mar 6;23(1):215. doi: 10.1186/s12913-023-09203-2.
Palliative care (PC) can improve the quality of life of Parkinson's disease (PD) patients and their carers. However, the impact of PC services on patients with PD remains unclear. This research was conducted to identify the barriers and facilitators influencing PC services for patients with PD based on the Social Ecological Model (SEM) framework.
This research was conducted through semi-structured interviews, employing SEM to organize themes and identify potential solutions across multiple levels.
A total of 29 interviewees (5 PD clinicians, 7 PD registered nurses, 8 patients, 5 caregivers, and 4 policy makers) completed the interviews. Facilitators and barriers were identified according to the levels of the SEM. Several facilitators were identified, i.e., (1) individual level: the critical needs among PD patients and their relatives and the desire for PC knowledge among health professionals; (2) interpersonal level: social support; (3) organizational level: the investments towards systematization of PC; and nurses are the bridge between patients and doctors; (4) community level: the convenience of community services; and hospital-community-family-based services; (5) culture and policy level: existing policy.
The social-ecological model proposed in this study helps illuminate the complex and multilevel factors that may influence PC delivery to PD patients.
姑息治疗（PC）可以提高帕金森病（PD）患者及其照顾者的生活质量。然而，PC 服务对 PD 患者的影响尚不清楚。本研究旨在根据社会生态模型（SEM）框架，确定影响 PD 患者 PC 服务的障碍和促进因素。
本研究通过半结构化访谈进行，采用 SEM 组织主题并识别多个层次的潜在解决方案。
共有 29 名受访者（5 名 PD 临床医生、7 名 PD 注册护士、8 名患者、5 名照顾者和 4 名政策制定者）完成了访谈。根据 SEM 的水平确定了促进因素和障碍。确定了一些促进因素，即（1）个体层面：PD 患者及其亲属的关键需求以及卫生专业人员对 PC 知识的渴望；（2）人际层面：社会支持；（3）组织层面：对 PC 系统化的投资；护士是患者和医生之间的桥梁；（4）社区层面：社区服务的便利性；以及医院-社区-家庭服务；（5）文化和政策层面：现有政策。
本研究提出的社会生态模型有助于阐明可能影响 PD 患者 PC 服务提供的复杂和多层次因素。
