Hellstrand Mikaela, Kornevs Maksims, Raghothama Jayanth, Meijer Sebastiaan
Division of Health Informatics and Logistics, KTH Royal Institute of Technology, Hälsovägen 11C, Huddinge, Sweden.
BMC Geriatr. 2024 Jan 25;24(1):98. doi: 10.1186/s12877-024-04693-z.
The implementation of a data-driven approach within the health care system happens in a rapid pace; including in the eldercare sector. Within Swedish eldercare, data-driven health approach is not yet widely implemented. In the specific context of long-term care for older adults, quality of care is as much determined by how social care is being performed as it is by what kind medical care that is provided. In particular, relational aspects have been proven to have a crucial influence on the experience of quality of care for the actors involved. Drawing on ethnographic material collected at a Swedish nursing home, this paper explores in what way the relational aspects of care could potentially become affected by the increased use of a data-driven health approach.
An ethnographic approach was adopted in order to investigate the daily care work at a long-term care facility as it unfolded. Fieldwork was conducted at a somatic ward in a Swedish long-term care facility over 4 months (86 h in total), utilizing the methods of participant observation, informal interviews and document analysis. The material was analyzed iteratively throughout the entire research process adopting thematic analysis.
Viewing our ethnographic material through an observational lense problematising the policy discourse around data-driven health approach, two propositions were developed. First, we propose that relational knowledge risk becoming less influential in shaping everyday care, when moving to a data-driven health approach. Second, we propose that quality of care risk becoming more directed on quality of medical care at the expense of quality of life.
While the implementation of data-driven health approach within long-term care for older adults is not yet widespread, the general development within health care points towards a situation in which this will become reality. Our study highlights the importance of taking the relational aspects of care into consideration, both during the planning and implementation phase of this process. By doing this, the introduction of a data-driven health approach could serve to heighten the quality of care in a way which supports both quality of medical care and quality of life.
医疗保健系统中数据驱动方法的实施正在迅速推进，老年护理领域亦是如此。在瑞典的老年护理中，数据驱动的健康方法尚未得到广泛应用。在老年人长期护理的特定背景下，护理质量不仅取决于所提供的医疗护理类型，还同样取决于社会护理的实施方式。特别是，已证明关系因素对相关行为者的护理质量体验具有至关重要的影响。本文借鉴在瑞典一家养老院收集的人种志资料，探讨护理的关系因素可能会以何种方式受到数据驱动健康方法使用增加的影响。
采用人种志方法来调查一家长期护理机构中日常护理工作的实际情况。在瑞典一家长期护理机构的一个内科病房进行了为期4个月（总计86小时）的实地研究，运用了参与观察、非正式访谈和文件分析等方法。在整个研究过程中，采用主题分析对资料进行反复分析。
通过观察视角审视我们的人种志资料，对围绕数据驱动健康方法的政策话语提出质疑，得出了两个观点。第一，我们认为，转向数据驱动的健康方法时，关系知识在塑造日常护理方面的影响力可能会减弱。第二，我们认为，护理质量可能会更侧重于医疗护理质量，而以生活质量为代价。
虽然数据驱动的健康方法在老年人长期护理中的应用尚未广泛普及，但医疗保健领域的总体发展表明这种情况将会成为现实。我们的研究强调了在这一过程的规划和实施阶段都要考虑护理的关系因素的重要性。通过这样做，引入数据驱动的健康方法可以以支持医疗护理质量和生活质量的方式提高护理质量。
