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分析加拿大安大略省接受家庭护理评估的成年人的医疗、功能、认知和心理社会护理需求:提倡在家中进行长期“生活护理”。

Profiling the medical, functional, cognitive, and psychosocial care needs of adults assessed for home care in Ontario, Canada: The case for long-term 'life care' at home.

机构信息

SE Research Centre, SE Health, Markham, Ontario, Canada.

Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.

出版信息

PLoS One. 2024 Apr 1;19(4):e0300521. doi: 10.1371/journal.pone.0300521. eCollection 2024.

Abstract

Calls to leverage routinely collected data to inform health system improvements have been made. Misalignment between home care services and client needs can result in poor client, caregiver, and system outcomes. To inform development of an integrated model of community-based home care, grounded in a holistic definition of health, comprehensive clinical profiles were created using Ontario, Canada home care assessment data. Retrospective, cross-sectional analyses of 2017-2018 Resident Assessment Instrument Home Care (RAI-HC) assessments (n = 162,523) were completed to group home care clients by service needs and generate comprehensive profiles of each group's dominant medical, functional, cognitive, and psychosocial care needs. Six unique groups were identified, with care profiles representing home care clients living with Geriatric Syndromes, Medical Complexity, Cognitive Impairment and Behaviours, Caregiver Distress and Social Frailty. Depending on group membership, between 51% and 81% of clients had identified care needs spanning four or more Positive Health dimensions, demonstrating both the heterogeneity and complexity of clients served by home care. Comprehensive clinical profiles, developed from routinely collected assessment data, support a future-focused, evidence-informed, and community-engaged approach to research and practice in integrated home-based health and social care.

摘要

已经有人呼吁利用常规收集的数据来为卫生系统的改进提供信息。家庭护理服务与客户需求之间的不匹配可能导致客户、护理人员和系统的不良结果。为了为基于社区的家庭护理综合模型的发展提供信息,并以健康的整体定义为基础,使用加拿大安大略省的家庭护理评估数据创建了全面的临床概况。对 2017-2018 年居民评估工具家庭护理(RAI-HC)评估(n=162523)进行了回顾性、横断面分析,根据服务需求对家庭护理客户进行分组,并为每个组的主要医疗、功能、认知和心理社会护理需求生成全面的概况。确定了六个独特的群体,每个群体的护理概况代表了患有老年综合征、医疗复杂性、认知障碍和行为、护理人员压力和社会脆弱性的家庭护理客户。根据群体成员的不同,51%至 81%的客户有跨越四个或更多积极健康维度的已确定护理需求,这表明家庭护理服务的客户既有异质性又有复杂性。从常规收集的评估数据中开发的全面临床概况,支持了未来为重点、以证据为依据、以社区为参与的综合家庭健康和社会护理研究和实践方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54dd/10984553/5802e224535f/pone.0300521.g001.jpg

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