老年人对加拿大老龄化、社区和健康研究单位-社区伙伴关系计划（ACHRU-CPP）用于糖尿病自我管理的体验和感知影响：一项定性描述性研究。
Older adults' experiences and perceived impacts of the Aging, Community and Health Research Unit-Community Partnership Program (ACHRU-CPP) for diabetes self-management in Canada: a qualitative descriptive study.
机构信息
School of Nursing, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada.
出版信息
BMJ Open. 2023 Apr 5;13(4):e068694. doi: 10.1136/bmjopen-2022-068694.
OBJECTIVES
To assess the experiences and perceived impacts of the Aging, Community and Health Research Unit-Community Partnership Program (ACHRU-CPP) from the perspectives of older adults with diabetes and other chronic conditions. The ACHRU-CPP is a complex 6-month self-management evidence-based intervention for community-living older adults aged 65 years or older with type 1 or type 2 diabetes and at least one other chronic condition. It includes home and phone visits, care coordination, system navigation support, caregiver support and group wellness sessions delivered by a nurse, dietitian or nutritionist, and community programme coordinator.
DESIGN
Qualitative descriptive design embedded within a randomised controlled trial was used.
SETTING
Six trial sites offering primary care services from three Canadian provinces (ie, Ontario, Quebec and Prince Edward Island) were included.
PARTICIPANTS
The sample was 45 community-living older adults aged 65 years or older with diabetes and at least one other chronic condition.
METHODS
Participants completed semistructured postintervention interviews by phone in English or French. The analytical process followed Braun and Clarke's experiential thematic analysis framework. Patient partners informed study design and interpretation.
RESULTS
The mean age of older adults was 71.7 years, and the mean length of time living with diabetes was 18.8 years. Older adults reported positive experiences with the ACHRU-CPP that supported diabetes self-management, such as improved knowledge in managing diabetes and other chronic conditions, enhanced physical activity and function, improved eating habits, and opportunities for socialisation. They reported being connected to community resources by the intervention team to address social determinants of health and support self-management.
CONCLUSIONS
Older adults perceived that a 6-month person-centred intervention collaboratively delivered by a team of health and social care providers helped support chronic disease self-management. There is a need for providers to help older adults connect with available health and social services in the community.
TRIAL REGISTRATION NUMBER
ClinicalTrials.gov ID: NCT03664583; Results.
目的
从患有糖尿病和其他慢性病的老年人的角度评估老龄化、社区和健康研究单位-社区伙伴关系计划（ACHRU-CPP）的经验和感知影响。ACHRU-CPP 是一项针对 65 岁及以上患有 1 型或 2 型糖尿病和至少一种其他慢性病的社区居住老年人的复杂的 6 个月自我管理循证干预措施。它包括家庭和电话访问、护理协调、系统导航支持、护理人员支持和由护士、营养师或营养学家以及社区项目协调员提供的小组健康课程。
设计
采用随机对照试验中嵌入的定性描述设计。
地点
来自加拿大三个省份（安大略省、魁北克省和爱德华王子岛）的六个提供初级保健服务的试验点。
参与者
样本为 45 名年龄在 65 岁及以上、患有糖尿病和至少一种其他慢性病的社区居住老年人。
方法
参与者通过电话以英语或法语完成半结构化的干预后访谈。分析过程遵循 Braun 和 Clarke 的经验主题分析框架。患者伙伴参与了研究设计和解释。
结果
老年人的平均年龄为 71.7 岁，平均患有糖尿病的时间为 18.8 年。老年人报告了对 ACHRU-CPP 的积极体验，这些体验支持了糖尿病的自我管理，例如改善了管理糖尿病和其他慢性病的知识、增强了身体活动和功能、改善了饮食习惯以及社交机会。他们报告说，干预团队将他们与社区资源联系起来，以解决健康的社会决定因素并支持自我管理。
结论
老年人认为，由一组健康和社会护理提供者共同提供的为期 6 个月的以患者为中心的干预措施有助于支持慢性病的自我管理。提供者需要帮助老年人与社区中现有的卫生和社会服务联系起来。
试验注册
ClinicalTrials.gov 标识符：NCT03664583；结果。
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