Curreri Nereide A, Griffiths Dave, Mccabe Louise
University of Applied Sciences & Arts of Southern Switzerland (SUPSI), CH.
University of Stirling, UK.
Int J Integr Care. 2024 Feb 27;24(1):15. doi: 10.5334/ijic.7630. eCollection 2024 Jan-Mar.
Action 3 of the UN Decade of Healthy Ageing plan is to deliver integrated care to improve older adults' lives. Integrated care is vital in meeting the complex needs of people with dementia but little is known about how this is or could be delivered in low and middle income countries (LMIC). This paper provides insights into previously unknown care system structures and on the potential and reality of delivering integrated care in Central America for people with dementia.
A social network analysis (SNA) methodology was adopted to engage with providers of services for older adults and families with dementia in Guatemala, El Salvador, Honduras, Costa Rica and Panama. Sixty-eight (68) semi-structured interviews were completed, 57 with organisations and 11 with families.
Across the five countries there was evidence of fragmentation and low integration within the dementia care systems. A variety of services and types of providers are present in all five countries, and high levels of diversified connections exist among organisations of differing disciplines. However, unawareness among network members about other members that they could potentially form active links with is a barrier on the path to integration.
This innovative and robust study demonstrates SNA can be applied to evaluate LMIC care systems. Findings provide baselines of system structures and insights into where resources are needed to fortify integration strategies. Results suggest that Central American countries have the building blocks in place to develop integrated care systems to meet the needs of people with dementia, but the links across service providers are opportunistic rather than context based coordinated integration policies.
联合国健康老龄化十年计划的行动3是提供综合护理以改善老年人生活。综合护理对于满足痴呆症患者的复杂需求至关重要，但对于在低收入和中等收入国家（LMIC）如何提供或可能提供这种护理，人们了解甚少。本文深入探讨了中美洲痴呆症患者护理系统结构中以前未知的情况，以及提供综合护理的潜力和现实情况。
采用社会网络分析（SNA）方法，与危地马拉、萨尔瓦多、洪都拉斯、哥斯达黎加和巴拿马为患有痴呆症的老年人及其家庭提供服务的机构进行交流。共完成了68次半结构化访谈，其中57次是与组织进行的，11次是与家庭进行的。
在这五个国家，痴呆症护理系统存在碎片化和整合程度低的迹象。所有五个国家都有各种各样的服务和服务提供者类型，不同学科的组织之间存在高度多样化的联系。然而，网络成员对他们可能与之建立积极联系的其他成员缺乏了解，这是整合道路上的一个障碍。
这项创新且有力的研究表明，社会网络分析可用于评估低收入和中等收入国家的护理系统。研究结果提供了系统结构的基线，并深入了解了加强整合战略所需资源的所在之处。结果表明，中美洲国家已具备发展综合护理系统以满足痴呆症患者需求的基础，但服务提供者之间的联系是机会主义的，而非基于背景的协调整合政策。
