NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
Amsterdam UMC Location Vrije Universiteit Amsterdam, APH Amsterdam Public Health research institute, Amsterdam, The Netherlands.
J Appl Res Intellect Disabil. 2024 May;37(3):e13223. doi: 10.1111/jar.13223.
To improve the quality of palliative care, six evidence-based tools were implemented in 10 care services specialised in care for people with intellectual disabilities. Contextual differences were taken into account by using a participatory action research approach.
The RE-AIM framework (Reach, Effectiveness, Adoption, Implementation and Maintenance) structured the evaluation. Data sources were online questionnaires completed by 299 professionals at baseline (response 45.2%) and 250 professionals after 2.5 years (35.1%), 11 semi-structured group interviews with 43 professionals, field notes and implementation plans.
A total of 767 professionals and 43 teams were reached. The effectiveness of the intervention was demonstrated in an improved knowledge of palliative care policy and increased competences among professionals. 79% of the professionals adopted tools in the toolbox. The participatory action research method was perceived as valuable in driving change.
Improving palliative care needs a context-specific, flexible approach, with involvement of all stakeholders.
为了提高姑息治疗的质量，在 10 个专门为智力残疾人士提供护理的护理服务中实施了 6 种基于证据的工具。采用参与式行动研究方法考虑了背景差异。
RE-AIM 框架（范围、有效性、采用、实施和维护）对评估进行了结构化。数据来源是基线时完成的 299 名专业人员的在线问卷（回应率为 45.2%）和 2.5 年后完成的 250 名专业人员的在线问卷（回应率为 35.1%），11 次与 43 名专业人员进行的半结构化小组访谈、现场记录和实施计划。
共接触到 767 名专业人员和 43 个团队。干预的有效性体现在对姑息治疗政策的认识提高和专业人员能力的提高。工具包中的工具被 79%的专业人员采用。参与式行动研究方法被认为是推动变革的有价值方法。
改善姑息治疗需要一种特定于背景的、灵活的方法，需要所有利益相关者的参与。
