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菲律宾和越南老年人需求满足方面的差距和机遇:对城市照护环境中卫生和社会工作者经验的定性探索。

Gaps and opportunities in addressing the needs of older adults in the Philippines and Vietnam: a qualitative exploration of health and social workers' experiences in urban care settings.

机构信息

Department of Health Policy and Administration, College of Public Health, University of the Philippines Manila, Manila, Philippines.

College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand.

出版信息

Front Public Health. 2024 Mar 22;12:1269116. doi: 10.3389/fpubh.2024.1269116. eCollection 2024.

Abstract

BACKGROUND

Despite numerous government initiatives, concerns and disparities among older adults have continually been growing. Empirical studies focused on older adults in the Philippines and Vietnam appear minimal and mostly regarding perceptions of aging. An effective geriatric care strongly relies on functional service providers requiring their perspectives to be explored toward inclusive service delivery.

OBJECTIVE

To investigate the perceived gaps and opportunities in geriatric care service delivery among health and social care workers in selected urban areas in the Philippines and Vietnam.

METHODS

A qualitative case study approach drawn on social constructivism theory, examined working experiences, observed characteristics of older adults, geriatric services and needs, difficulties on service delivery, and recommended solutions. A total of 12 semi-structured interviews and 29 focus group discussions were conducted in the Philippines, with 174 health and social care workers, while in Vietnam, there were 23 semi-structured interviews and 29 focus group discussions with 124 participants. An inductive thematic analysis was employed.

RESULTS

Interview participants highlighted the increasing unmet needs such as accessibility, availability, and acceptability of geriatric care services. The implementation of interventions on the older population faced multiple challenges, including issues related to older adult conundrums and dilemmas in geriatric care providers and facilities. The participants from the two countries felt that strengthening implementation of collaboration toward an integrated geriatric care structure and expansion of training and capability in handling older adults can be potential in addressing the gaps at both individual and institutional levels. Additionally, a committed leadership was viewed to be the important step to effectively operationalize the strategy.

CONCLUSION

Health and social workers emphasized that the needs of older adults are exacerbated by various challenges within a fragmented geriatric care system. To address this issue, an establishment of an integrated service delivery mechanism with dedicated leadership is needed. The findings from this study may help develop appropriate solutions for addressing the health and social care needs of older adults in similar settings across Southeast Asia. Further examination of the impact of these challenges and solutions on service delivery and the wellbeing of older adults is essential.

摘要

背景

尽管政府采取了众多举措,但老年人的问题和差距仍在不断扩大。针对菲律宾和越南老年人的实证研究似乎很少,而且大多集中在对老龄化的看法上。有效的老年护理服务强烈依赖于功能服务提供者,需要探索他们的观点,以实现包容性的服务提供。

目的

调查菲律宾和越南选定城市地区的卫生和社会保健工作者对老年护理服务提供的认知差距和机会。

方法

采用基于社会建构主义理论的定性案例研究方法,研究了工作经验、观察老年人的特征、老年服务和需求、服务提供的困难以及建议的解决方案。在菲律宾共进行了 12 次半结构式访谈和 29 次焦点小组讨论,共有 174 名卫生和社会保健工作者参与;在越南,共进行了 23 次半结构式访谈和 29 次焦点小组讨论,有 124 人参与。采用归纳主题分析。

结果

访谈参与者强调了日益增长的未满足需求,如老年护理服务的可及性、可用性和可接受性。针对老年人群的干预措施的实施面临着多重挑战,包括与老年护理提供者和设施相关的老年困境和困境问题。来自这两个国家的参与者认为,加强合作实施综合老年护理结构以及扩大培训和处理老年人的能力,可能有助于解决个人和机构层面的差距。此外,他们认为,坚定的领导力是有效实施该战略的重要步骤。

结论

卫生和社会工作者强调,在一个分散的老年护理系统中,各种挑战加剧了老年人的需求。为了解决这个问题,需要建立一个有专门领导的综合服务提供机制。本研究的结果可能有助于为东南亚类似环境中满足老年人的卫生和社会保健需求制定适当的解决方案。进一步研究这些挑战和解决方案对服务提供和老年人福祉的影响至关重要。

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