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[以全科医生为中心的痴呆症护理项目对满意度、缓解情况与工作量的评估:德国哥廷根的痴呆症早期信息与支持项目(FIDEM)]

[Evaluation of satisfaction with and relief vs. workload by a general practitioner-centered dementia care project: early information and support in dementia (FIDEM) in Göttingen, Germany].

作者信息

Demmer Iris, Belz Michael, Oberbach Lea, Hummers Eva, Wiltfang Jens, Bartels Claudia

机构信息

Institut für Allgemeinmedizin, Universitätsmedizin Göttingen, Göttingen, Deutschland.

Klinik für Psychiatrie und Psychotherapie, Universitätsmedizin Göttingen, Von-Sieboldt-Straße 5, 37075, Göttingen, Deutschland.

出版信息

Nervenarzt. 2023 Nov;94(11):1034-1042. doi: 10.1007/s00115-023-01557-6. Epub 2023 Oct 5.

Abstract

BACKGROUND

Early information and support in dementia (FIDEM) is a cross-sectoral, general practitioner-centered network model for the improvement of community-based care of people with dementia and their caregivers by systematically assigning them to non-physician healthcare providers.

OBJECTIVE

To describe the implementation of FIDEM in Göttingen, Germany and to exploratorily evaluate satisfaction and relief vs. additional workload.

MATERIAL AND METHODS

FIDEM was established in Göttingen in 2017. Community-based and district-based networks consisted of medical (general practitioners) and non-medical cooperation partners (occupational therapists, care counselling, other non-medical care providers) and were instructed to efficiently share information. During biannual network meetings from August 2017 to October 2019, a self-developed questionnaire for quality management and evaluation of the aspects of the project described above was filled out by participants attending the meetings.

RESULTS

Consecutive recruitment resulted in 7 networks by October 2019, with participation of 29 general practitioners and 46 non-medical care providers, serving as cooperation partners. Quantitative evaluation of 80 FIDEM cooperation partners revealed high satisfaction ratings with all aspects of the model (M from 7.22 to 7.87 out of possible "10"), with partially higher ratings on the part of primary care physicians. Furthermore, all participants reported a reduction in workload due to participation, which was significantly higher for primary care physicians across all scales (all p-values < 0.001).

CONCLUSION

FIDEM has been implemented in Göttingen beyond a funded pilot project phase. High satisfaction ratings and considerable relief in workload suggest the continuation of FIDEM along with a full evaluation and, provided positive results, its consolidation of and transfer to other regions in Germany.

摘要

背景

痴呆症早期信息与支持计划(FIDEM)是一种跨部门、以全科医生为中心的网络模式,通过系统地将痴呆症患者及其护理人员分配给非医生医疗服务提供者,改善基于社区的痴呆症患者及其护理人员的护理。

目的

描述FIDEM在德国哥廷根的实施情况,并探索性评估满意度、负担减轻情况与额外工作量。

材料与方法

FIDEM于2017年在哥廷根建立。基于社区和地区的网络由医疗合作方(全科医生)和非医疗合作方(职业治疗师、护理咨询人员、其他非医疗护理提供者)组成,并被要求高效共享信息。在2017年8月至2019年10月的半年一次的网络会议期间,参加会议的人员填写了一份自行开发的用于质量管理和评估上述项目各方面情况的问卷。

结果

持续招募使得截至2019年10月形成了7个网络,有29名全科医生和46名非医疗护理提供者作为合作方参与其中。对80名FIDEM合作方的定量评估显示,他们对该模式的各个方面满意度都很高(评分从7.22到7.87,满分“10”分),初级保健医生的评分部分更高。此外,所有参与者都报告称参与该计划后工作量有所减少,在所有量表上,初级保健医生的工作量减少幅度显著更高(所有p值均<0.001)。

结论

FIDEM已在哥廷根实施,超出了资助试点项目阶段。高满意度评分和工作量的显著减轻表明,FIDEM应继续进行全面评估,若结果积极,则应在德国其他地区巩固并推广。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f295/10620282/c30992f8d95b/115_2023_1557_Fig1_HTML.jpg

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