School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.
School of Public Health-Bloomington, Indiana University, Bloomington, Indiana, USA.
J Hosp Med. 2024 Jan;19(1):35-39. doi: 10.1002/jhm.13231. Epub 2023 Oct 25.
Since most care for children with medical complexity (CMC) is delivered daily in communities by multiple caregiving individuals, that is, caregiving networks, tools to assess and intervene across these networks are needed. This study evaluated the feasibility of applying social network analysis (SNA) to describe caregiving networks. Because hospitalization is among the most frequently used outcomes for CMC, exploratory correlations between network characteristics and CMC hospital use were evaluated. Within 3 weeks, the goal network enrollment was achieved, and all feasibility measures were favorable. Network characteristics correlated with hospital use, that is, smaller, denser networks, with more closed-loop communication correlated with fewer hospital days. Networks with more professional caregivers also correlated with fewer hospital days. SNA is a feasible tool to study CMC caregiving networks. Preliminary data support rigorous hypothesis testing using SNA methods. Network-based interventions to improve CMC health may be an important future direction.
由于大多数对患有复杂疾病的儿童（CMC）的护理都是由多个照顾者在社区中提供的，也就是说，需要有工具来评估和干预这些网络中的护理关系。本研究评估了应用社会网络分析（SNA）来描述护理关系网络的可行性。由于住院是 CMC 最常用的结果之一，因此评估了网络特征与 CMC 住院使用之间的探索性相关性。在 3 周内，达到了目标网络的入组人数，并且所有可行性指标都很好。网络特征与住院使用相关，即较小、较密集的网络，以及更多的闭环沟通与较少的住院天数相关。具有更多专业护理人员的网络也与较少的住院天数相关。SNA 是研究 CMC 护理关系网络的一种可行工具。初步数据支持使用 SNA 方法进行严格的假设检验。基于网络的干预措施可能是改善 CMC 健康的一个重要未来方向。
