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从业者远程理解个性化护理和支持计划的能力:来自 Dementia Personalised Care Team(D-PACT)干预措施可行性阶段的多种数据源的主题分析。

Practitioners' ability to remotely develop understanding for personalised care and support planning: a thematic analysis of multiple data sources from the feasibility phase of the Dementia Personalised Care Team (D-PACT) intervention.

机构信息

Community and Primary Care Research Group, University of Plymouth, Plymouth, UK.

Centre for Ageing Population Studies, Research Department of Primary Care and Population Health, University College London, London, UK.

出版信息

Dementia (London). 2023 Oct;22(7):1461-1486. doi: 10.1177/14713012231185281. Epub 2023 Jun 24.

DOI:10.1177/14713012231185281
PMID:37354084
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10521162/
Abstract

Practitioner understanding of patients' preferences, wishes and needs is essential for personalised health care i.e., focusing on 'what matters' to people based on their individual life situation. To develop such an understanding, dementia practitioners need to use communication practices that help people share their experiences, preferences, and priorities. Following the COVID-19 pandemic, dementia support is likely to continue to be delivered both remotely and in-person. This study analysed multiple sources of qualitative data to examine the views of practitioners, people living with dementia and carers, and researchers on how an understanding of what matters to people living with dementia can be developed remotely via telephone and video call. Access to environmental stimuli, the remote use of visual tools, peoples' tendency to downplay or omit details about their troubles and carers' ability to disclose privately were interpreted, through thematic analysis, to be factors affecting how practitioners sought to develop understanding remotely. Cumulatively, findings show that while remote support created unique challenges to practitioners' ability to develop understanding for personalised care, practitioners developed adaptive strategies to overcome some of these challenges. Further research should examine how, when and for whom these adapted practices for remote personalised care work, informing the development of evidence-based guidance and training on how practitioners can remotely develop the understanding required for personalised care.

摘要

从业者对患者偏好、意愿和需求的理解对于个性化医疗至关重要,即根据个人生活情况关注“对人们重要的事情”。为了培养这种理解,痴呆症从业者需要使用有助于人们分享经验、偏好和优先事项的沟通实践。在 COVID-19 大流行之后,痴呆症支持可能继续通过远程和面对面的方式提供。本研究分析了多种定性数据来源,以探讨从业者、与痴呆症患者生活在一起的人和护理人员以及研究人员的观点,即如何通过电话和视频电话远程了解对与痴呆症患者重要的事情。通过主题分析,对环境刺激的获取、远程使用视觉工具、人们倾向于淡化或省略其烦恼的细节以及护理人员披露隐私的能力进行了解释,这些因素影响了从业者远程寻求理解的方式。总之,研究结果表明,尽管远程支持给从业者为个性化护理培养理解的能力带来了独特的挑战,但从业者制定了适应性策略来克服其中的一些挑战。进一步的研究应探讨这些远程个性化护理的适应性实践在何时以及对哪些人有效,为从业者如何远程发展个性化护理所需的理解提供循证指导和培训。

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Access to personalised dementia care planning in primary care: a mixed methods evaluation of the PriDem intervention.初级保健中个性化痴呆症护理计划的获取:PriDem 干预措施的混合方法评估。
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Clin Gerontol. 2023 Jul-Sep;46(4):511-524. doi: 10.1080/07317115.2022.2085643. Epub 2022 Jun 7.
2
Delivering Cognitive Stimulation Therapy (CST) Virtually: Developing and Field-Testing a New Framework.远程提供认知刺激疗法(CST):开发和现场测试新框架。
Clin Interv Aging. 2022 Feb 9;17:97-116. doi: 10.2147/CIA.S348906. eCollection 2022.
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'Do I have the capacity to make capacity judgements?' Researcher reflections from a person-centred dementia support study.“我有能力做出能力判断吗?”一项以患者为中心的痴呆症支持研究中的研究人员反思。
Dementia (London). 2022 Apr;21(3):972-994. doi: 10.1177/14713012211067320. Epub 2022 Feb 11.
4
Using video consultations to support family carers of people living with dementia.利用视频咨询为痴呆症患者的家庭护理者提供支持。
Nurs Older People. 2022 Feb 1;34(1):28-33. doi: 10.7748/nop.2021.e1346. Epub 2021 Aug 25.
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Online singing groups for people with dementia: scoping review.在线歌唱团体对痴呆症患者的影响:综述研究。
Public Health. 2021 May;194:196-201. doi: 10.1016/j.puhe.2021.03.002. Epub 2021 May 4.
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Adaptation of an online training and support program for caregivers of people with dementia to Indian cultural setting.将针对痴呆症患者照料者的在线培训与支持项目改编至印度文化背景。
Asian J Psychiatr. 2021 May;59:102624. doi: 10.1016/j.ajp.2021.102624. Epub 2021 Feb 28.
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GP trainee responses to using SHERPA for multimorbidity consultations.全科医生培训生对使用 SHERPA 进行多病种咨询的反应。
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Remote primary care consultations for people living with dementia during the COVID-19 pandemic: experiences of people living with dementia and their carers.远程初级保健咨询在 COVID-19 大流行期间为痴呆症患者提供:痴呆症患者及其护理人员的体验。
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