影响老年人居住综合健康和社会护理客户体验的因素和机制：中国机构环境下的定性模型。
Factors and Mechanism Influencing Client Experience of Residential Integrated Health and Social Care for Older People: A Qualitative Model in Chinese Institutional Settings.
机构信息
Center for Social Security Studies, Wuhan University, Wuhan 430072, China.
School of Public Administration, Central South University, Changsha 410075, China.
出版信息
Int J Environ Res Public Health. 2023 Mar 6;20(5):4638. doi: 10.3390/ijerph20054638.
BACKGROUND
An emerging service delivery model of integrating health and social care for older people has been actively promoted by the Chinese government since 2016, but the client experience and influencing mechanism still remain unclear.
METHODS
this study adopts a qualitative methodology to delve deeper into the factors and mechanism shaping the client experience of residential integrated health and social care for older people in the Chinese context, so as to understand the experiences of older residents during the whole process of receiving integrated care services, and on this basis, put forward suggestions for the improvement of a high-quality aged care service system. We coded and analyzed the in-depth interview data of twenty older adults and six staff members from June 2019 to February 2020, recruited from six institutions in Changsha, one of the ninety pilot cities for integrated health and social care in China.
RESULTS
the findings showed that the client experience of older adults is mainly affected by factors in three dimensions (scene construction, individual minds, and interaction and communication), which are comprised of six sub-categories (social foundation, institutional functions, perception and emotion, cognition and understanding, intimacy and trust, and participation). Based on the factors and mechanism (consisting of six influencing paths), we constructed a model of the client experience of integrated health and social care for older people in the Chinese population.
CONCLUSIONS
the factors and mechanism influencing the client experience of integrated health and social care for older people are complex and multifaceted. Attention should be paid to the direct effects of perception and emotion, institutional functions, intimacy and trust in the client experience, and the indirect effects of social foundation and participation on the client experience.
背景
自 2016 年以来，中国政府积极推行将医疗和社会护理整合为一体的新兴服务提供模式，为老年人提供服务，但客户体验和影响机制仍不清楚。
方法
本研究采用定性方法深入探讨影响中国老年人居住综合健康和社会护理客户体验的因素和机制，以了解老年居民在接受综合护理服务全过程中的体验，并在此基础上提出改善高质量老年护理服务体系的建议。我们对 2019 年 6 月至 2020 年 2 月期间从中国 90 个综合卫生和社会护理试点城市之一的长沙市的六家机构招募的 20 名老年人和 6 名工作人员的深入访谈数据进行了编码和分析。
结果
研究结果表明，老年人的客户体验主要受三个维度（场景构建、个体思维和互动与沟通）的因素影响，这些因素包括六个子类别（社会基础、机构功能、感知和情感、认知和理解、亲密和信任以及参与）。基于这些因素和机制（包括六个影响路径），我们构建了中国人口中老年人综合健康和社会护理客户体验的模型。
结论
影响老年人综合健康和社会护理客户体验的因素和机制是复杂和多方面的。应关注感知和情感、机构功能、亲密和信任对客户体验的直接影响，以及社会基础和参与对客户体验的间接影响。
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