Fanaki Chaimaa, Fortin Julie, Sirois Marie-Josée, Kröger Edeltraut, Elliott Jacobi, Stolee Paul, Gregg Susie, Sims-Gould Joanie, Giguere Anik
VITAM-Research Centre On Sustainable Health, Quebec, QC.
Quebec Centre for Excellence on Aging, Quebec, QC.
Can Geriatr J. 2023 Jun 1;26(2):227-238. doi: 10.5770/cgj.26.646. eCollection 2023 Jun.
To help recognize and care for community-dwelling older adults living with frailty, we plan to implement a primary care pathway consisting of frailty screening, shared decision-making to select a preventive intervention, and facilitated referral to community-based services. In this study, we examined the potential factors influencing adoption of this pathway.
In this qualitative, descriptive study, we conducted semi-structured interviews and focus groups with patients aged 70 years and older, health professionals (HPs), and managers from four primary care practices in the province of Quebec, representatives of community-based services and geriatric clinics located near the practices. Two researchers conducted an inductive/deductive thematic analysis, by first drawing on the and then adding emergent subthemes.
We recruited 28 patients, 29 HPs, and 8 managers from four primary care practices, 16 representatives from community-based services, and 10 representatives from geriatric clinics. Participants identified several factors that could influence adoption of the pathway: the availability of electronic and printed versions of the decision aids; the complexity of including a screening form in the electronic health record; public policies that limit the capacity of community-based services; HPs' positive attitudes toward shared decision-making and their work overload; and lack of funding.
These findings will inform the implementation of the care pathway, so that it meets the needs of key stakeholders and can be scaled up.
为了帮助识别和照顾社区中体弱的老年人，我们计划实施一条初级保健途径，该途径包括体弱筛查、共同决策以选择预防性干预措施，以及促进转介至社区服务。在本研究中，我们考察了影响采用该途径的潜在因素。
在这项定性描述性研究中，我们对70岁及以上的患者、卫生专业人员（HP）以及魁北克省四家初级保健机构的管理人员、这些机构附近的社区服务代表和老年诊所代表进行了半结构化访谈和焦点小组讨论。两名研究人员进行了归纳/演绎主题分析，首先借鉴[相关内容未提及]，然后添加新出现的子主题。
我们从四家初级保健机构招募了28名患者、29名卫生专业人员和8名管理人员，从社区服务机构招募了16名代表，从老年诊所招募了10名代表。参与者确定了几个可能影响采用该途径的因素：决策辅助工具的电子和印刷版本的可用性；在电子健康记录中纳入筛查表的复杂性；限制社区服务能力的公共政策；卫生专业人员对共同决策的积极态度及其工作负担过重；以及资金短缺。
这些发现将为护理途径的实施提供信息，使其满足关键利益相关者的需求并得以扩大推广。
