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澳大利亚老年护理工作者在试行姑息治疗结果计划期间的体验。

The experience of Australian aged care workers during a trial implementation of a palliative care outcomes programme.

机构信息

Centre for Health Research Illawarra Shoalhaven Population, University of Wollongong, Wollongong, New South Wales, Australia.

Palliative Care Outcomes Collaboration, University of Wollongong, Wollongong, New South Wales, Australia.

出版信息

Int J Health Plann Manage. 2024 Mar;39(2):380-396. doi: 10.1002/hpm.3731. Epub 2023 Nov 9.

Abstract

End of life care is an essential part of the role of Australian aged care homes (ACHs). However, there is no national framework to support aged care staff in systematically identifying residents with palliative care needs or to routinely assess, respond to, and measure end of life needs. The Palliative Care Outcomes Collaboration (PCOC) is a national outcomes and benchmarking programme which aims to systematically improve palliative care for people who are approaching the end of life, and for their families and carers. The PCOC Wicking Model for Residential Aged Care was developed and piloted in four Australian ACHs. This paper reports on the qualitative findings from semi-structured interviews and focus groups conducted with ACH staff (N = 37) to examine feasibility. Thematic analysis identified three overarching themes about the pilot: (i) processes to successfully prepare and support ACHs; (ii) appropriateness of PCOC tools for the ACH setting; and (iii) realised and potential benefits of the model for ACHs. The lessons presented valuable insights to refine the PCOC Wicking Model and enrich understanding of the potential challenges and solutions for implementing similar programs within ACHs in future. The results suggest that key to successfully preparing ACHs for implementation of the PCOC Wicking Model is an authentic and well-paced collaborative approach with ACHs to ensure the resources, structures and systems are in place and appropriate for the setting. The PCOC Wicking Model for Residential Aged Care is a promising prototype to support ACHs in improving palliative and end of life care outcomes for residents and their carers.

摘要

临终关怀是澳大利亚老年护理院(ACH)职责的重要组成部分。然而,ACH 护理人员并没有国家框架来系统地识别有姑息治疗需求的居民,也没有常规评估、应对和衡量临终需求的框架。姑息治疗结果协作组织(PCOC)是一个全国性的结果和基准计划,旨在系统地改善临终患者及其家属和护理人员的姑息治疗。PCOC Wicking 模式为澳大利亚的四家 ACH 开发并进行了试点。本文报告了对 ACH 工作人员(N=37)进行的半结构化访谈和焦点小组的定性发现,以检验可行性。主题分析确定了试点的三个总体主题:(i)成功准备和支持 ACH 的过程;(ii)PCOC 工具在 ACH 环境中的适宜性;(iii)该模型对 ACH 的实现和潜在益处。这些经验教训为完善 PCOC Wicking 模型提供了有价值的见解,并丰富了对未来在 ACH 中实施类似计划的潜在挑战和解决方案的理解。结果表明,ACH 成功准备实施 PCOC Wicking 模型的关键是与 ACH 建立真实和有节奏的合作方法,以确保资源、结构和系统到位并适合该环境。姑息治疗结果协作组织的住宅老年护理 Wicking 模式是支持 ACH 改善居民及其护理人员的姑息治疗和临终关怀结果的有前途的原型。

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