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德国日间临终关怀医院和姑息治疗日间护理诊所的额外益处的专家观点:定性方法。

Expert Perspectives on the Additional Benefit of Day Hospices and Palliative Day Care Clinics in Germany: A Qualitative Approach.

机构信息

Hannover Medical School, Institute for General Practice and Palliative Care, Hannover, Germany.

Bielefeld University of Applied Sciences, Faculty of Engineering and Mathematics, Bielefeld, Germany.

出版信息

Am J Hosp Palliat Care. 2024 Feb;41(2):167-172. doi: 10.1177/10499091231168574. Epub 2023 Apr 5.

Abstract

In Germany, hospice and palliative care is well covered through inpatient, outpatient, and home-based care services. It is unknown if, and to what extent, there is a need for additional day care services to meet the specific needs of patients and caregivers. Two day hospices and two palliative day care clinics were selected. In the first step, two managers from each facility ( = 8) were interviewed by telephone, using a semi-structured interview guide. In the second step, four focus groups were conducted, each with three to seven representatives of hospice and palliative care from the facilities' hospice and palliative care networks. Interviews and focus groups were audio recorded, transcribed verbatim and analyzed using qualitative content analysis. The interviewed experts perceived day care services as providing additional patient and caregiver benefits. Specifically, the services were perceived to meet patient needs for social interaction and bundled treatments, especially for patients who did not fit into inpatient settings (due to, e.g., their young age or a lack of desire for inpatient admission). The services were also perceived to meet caregiver needs for support, providing short-term relief for the home care situation. The results suggest that inpatient, outpatient, and home-based hospice and palliative care services do not meet the palliative care needs of all patients. Although the population that is most likely to benefit from day care services is assumed to be relatively small, such services may meet the needs of certain patient groups more effectively than other forms of care.

摘要

在德国,临终关怀和姑息治疗通过住院、门诊和家庭护理服务得到很好的覆盖。目前尚不清楚是否需要额外的日托服务,以及需要到何种程度,以满足患者和护理人员的特定需求。选择了两家日间临终关怀院和两家姑息治疗日间护理诊所。在第一步中,每个机构的两名管理人员(= 8 人)通过电话接受了半结构化访谈指南的采访。在第二步中,举行了四个焦点小组,每个小组有来自机构的临终关怀网络的三至七名临终关怀和姑息治疗代表。采访和焦点小组进行了录音、逐字转录,并使用定性内容分析进行了分析。接受采访的专家认为日托服务为患者和护理人员提供了额外的好处。具体而言,这些服务被认为满足了患者对社交互动和综合治疗的需求,特别是对于那些不适合住院治疗的患者(例如,由于年龄较小或不希望住院治疗)。这些服务还被认为满足了护理人员对支持的需求,为家庭护理情况提供了短期缓解。研究结果表明,住院、门诊和家庭临终关怀和姑息治疗服务无法满足所有患者的姑息治疗需求。尽管最有可能从日托服务中受益的人群规模相对较小,但与其他形式的护理相比,这些服务可能更能满足某些患者群体的需求。

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