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虚弱老年人照护中合作的意愿和障碍:初级保健专业人员的观点。

The willingness and barriers to collaborate in the care of frail older adults: perspectives of primary care professionals.

机构信息

Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 7, Leuven, 3000, Belgium.

CEBAM Belgian Center for Evidence-based Medicine vzw, Kapucijnenvoer 7, Leuven, 3000, Belgium.

出版信息

BMC Geriatr. 2023 Aug 11;23(1):488. doi: 10.1186/s12877-023-04163-y.

Abstract

BACKGROUND

This study investigated the perspectives of primary care professionals, in particular general practitioners, registered nurses, physiotherapists and occupational therapists, on inter-professional collaboration, the barriers and the facilitators they perceive in the care of the frail older population.

METHODS

We conducted a qualitative study. In-depth interviews with healthcare professionals were performed, using open-ended questions about their perceptions on the care of frail older adults and inter-professional collaboration. Data was analyzed following the Basic Logical Model of Abduction and Creswell's coding method.

RESULTS

Healthcare professionals indicated that when they explored problems complementary to the reasons for older people to contact a healthcare professional, these additional problems often seemed to be the main problem. They also stated that there was too little inter-professional collaboration in the care of complex chronic issues and lack of a shared vision on collaboration. Collaboration is still limited too much to contacting established professions. Health information technology can support both, inter-professional collaboration and working on an evidence-based manner. It can also be a facilitator to inform patients. The availability and use of health information technology differs between the professions. Success factors and barriers for sustainable collaboration were identified on several levels, namely innovation, individual, professional, patient, social context, context of the organization, economic and political context.

CONCLUSIONS

Our study shed light on the willingness and barriers in collaboration of healthcare professionals in primary care for older adults. There is little inter-professional collaboration, despite the willingness of the healthcare professionals to collaborate.

摘要

背景

本研究调查了初级保健专业人员(特别是全科医生、注册护士、物理治疗师和职业治疗师)对跨专业合作的看法,以及他们在照顾体弱老年人方面所感知到的障碍和促进因素。

方法

我们进行了一项定性研究。对医疗保健专业人员进行了深入访谈,使用开放式问题询问他们对体弱老年人护理和跨专业合作的看法。数据按照演绎逻辑模型的基本逻辑和克雷斯韦尔的编码方法进行分析。

结果

医疗保健专业人员表示,当他们探索与老年人联系医疗保健专业人员的原因互补的问题时,这些额外的问题似乎往往是主要问题。他们还指出,在复杂的慢性问题的护理中,跨专业合作太少,缺乏对合作的共同愿景。合作仍然过于局限于联系既定的专业。健康信息技术可以支持跨专业合作和基于证据的工作。它也可以作为向患者提供信息的促进因素。在几个层面上确定了可持续合作的成功因素和障碍,即创新、个人、专业、患者、社会背景、组织背景、经济和政治背景。

结论

我们的研究揭示了初级保健中老年患者医疗保健专业人员合作的意愿和障碍。尽管医疗保健专业人员有合作的意愿,但跨专业合作很少。

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