University of California, Davis, Sacramento, California, USA.
VA Providence Healthcare System and Brown University School of Public Health, Providence, Rhode Island, USA.
J Am Geriatr Soc. 2024 Feb;72(2):361-368. doi: 10.1111/jgs.18686. Epub 2023 Nov 25.
As care shifts from institutional to community settings, family caregivers are providing increasing support to older adults, including complex medical/nursing care. In the mid-late pandemic, technology advancements such as use of online patient portals present opportunities for communication and care delivery. This study aims to assess the association between caregiver medical/nursing tasks or patient portal use with contact, communication, and training of caregivers by healthcare providers.
We conducted a cross-sectional analysis of caregiver data from the 2021 National Study of Caregiving (NSOC), linked to the National Health and Aging Trends Study (NHATS). NHATS is nationally-representative, annual survey of Medicare enrollees; NSOC surveys family/unpaid caregivers of NHATS participants. Logistic regression tested association between whether the caregiver does medical/nursing tasks or uses an online patient portal to contact the medical team (independent variables), and communication with or training by the medical team (dependent variables).
Participants were 1590 caregivers of living, community-dwelling older adults. More than half (54%) reported no contact with the care recipient's medical team in the past year. Caregivers who did medical/nursing tasks (OR = 3.10; 95% CI: 2.16, 4.46) or who used patient portals (OR = 3.28; 95% CI: 1.96, 5.51) had higher odds of contacting the older adult's medical team. Thirty percent of caregivers stated communication was either not at all or just a little helpful. Sixty-seven percent reported that providers rarely asked if they needed help managing the older adult's treatments. Just 6% of caregivers reported receiving any caregiver training in the last year.
Both medical/nursing tasks and online patient portal use were independently associated with contact with health providers. Overall contact, communication, and training were limited or of variable value. Despite recent policy changes and technology advancement, there is still a need for improved integration of caregivers into health teams with ongoing assessment of their needs.
随着护理工作从医疗机构向社区转移，家庭照顾者为老年人提供的支持越来越多，包括复杂的医疗/护理工作。在大流行的中后期，在线患者门户等技术的进步为沟通和护理提供了机会。本研究旨在评估照顾者的医疗/护理任务或患者门户使用与医疗保健提供者与照顾者的联系、沟通和培训之间的关联。
我们对 2021 年全国护理研究（NSOC）中的照顾者数据进行了横断面分析，该研究与国家健康老龄化趋势研究（NHATS）相关联。NHATS 是一项对医疗保险参保者进行的全国代表性年度调查；NSOC 调查 NHATS 参与者的家庭/无薪照顾者。逻辑回归测试了照顾者是否执行医疗/护理任务或使用在线患者门户与医疗团队联系（自变量），以及与医疗团队的沟通或培训（因变量）之间的关联。
参与者为 1590 名生活在社区的老年患者的家庭照顾者。超过一半（54%）的人报告在过去一年中没有与护理接受者的医疗团队联系。执行医疗/护理任务的照顾者（OR=3.10；95%CI：2.16，4.46）或使用患者门户的照顾者（OR=3.28；95%CI：1.96，5.51）与医疗团队联系的可能性更高。30%的照顾者表示沟通要么根本没有帮助，要么只是有一点帮助。67%的人报告说，提供者很少询问他们是否需要帮助管理老年人的治疗。只有 6%的照顾者报告在过去一年中接受过任何照顾者培训。
医疗/护理任务和在线患者门户的使用均与与医疗保健提供者的联系独立相关。总体联系、沟通和培训是有限的或具有不同的价值。尽管最近的政策变化和技术进步，但仍需要改善照顾者与医疗团队的整合，并对他们的需求进行持续评估。
