全科医疗中针对老年人的目标达成评定法：一项可行性研究。
Goal attainment scaling with older people in general practice: A feasibility study.
作者信息
van Blijswijk Sophie Ce, Gussekloo Jacobijn, Heijmans Florentine M, Wind Annet W, den Elzen Wendy Pj, Blom Jeanet W
机构信息
Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Postzone V0-P, Postbus 9600, 2300 RC Leiden, the Netherlands.
Department of Internal Medicine, section Gerontology and Geriatrics, Leiden University Medical Center, Hippocratespad 21, Postzone V0-P, Postbus 9600, 2300 RC Leiden, the Netherlands.
出版信息
Int J Nurs Stud Adv. 2020 Dec 15;3:100015. doi: 10.1016/j.ijnsa.2020.100015. eCollection 2021 Nov.
BACKGROUND
The impact of health problems on daily life and consequent treatment goals differ from person to person, particularly for older people with multiple health problems. Personalized care in general practice can help address these health problems, but evaluation of its effects remains difficult. In rehabilitation, a common approach to the evaluation of personalized care is Goal Attainment Scaling. This feasibility study assesses whether goal attainment scaling can also be applied to the evaluation of personal care for community-dwelling older people in general practice.
METHODS
General practices were invited to participate in this longitudinal, observational feasibility study. Practice nurses and general practitioners received training in care plans and goal attainment scaling. They were each asked to create care plans and goal attainment scales for patients (aged ≥75 years) and to carry out evaluations at three and six months. Professionals and patients both completed a short questionnaire to evaluate their experiences regarding the (dis)advantages of goal attainment scaling.
RESULTS
Professionals (=10) and patients (=23) were able to set goals and scales (=57) for problems across five health domains (somatic, functional, social, psychological and communicative), but experienced difficulties formulating goals and corresponding goal attainment scaling levels. Reported benefits of goal attainment scaling were 1) important problems were addressed, 2) patients were involved and motivated to attain goals, and 3) evaluation was straightforward once a scale was created. Disadvantages were 1) difficult for older people, 2) time-consuming and complex for clinical practice.
CONCLUSIONS
Goal attainment scaling shows potential benefit for clinical practice and general practice research in terms of the setting and evaluation of goals for community-dwelling older persons. Further research is needed to develop more standardized and less time-consuming goal attainment scaling methods.
背景
健康问题对日常生活的影响以及由此产生的治疗目标因人而异，对于患有多种健康问题的老年人来说尤其如此。全科医疗中的个性化护理有助于解决这些健康问题，但对其效果的评估仍然困难。在康复领域，评估个性化护理的一种常用方法是目标达成量表法。本可行性研究评估目标达成量表法是否也可应用于评估全科医疗中社区居住老年人的个性化护理。
方法
邀请全科医疗机构参与这项纵向观察性可行性研究。执业护士和全科医生接受了护理计划和目标达成量表法方面的培训。他们各自被要求为患者（年龄≥75岁）制定护理计划和目标达成量表，并在三个月和六个月时进行评估。专业人员和患者都完成了一份简短问卷，以评估他们对目标达成量表法（不）足之处的体验。
结果
专业人员（=10）和患者（=23）能够针对五个健康领域（躯体、功能、社会、心理和沟通）的问题设定目标和量表（=57），但在制定目标和相应的目标达成量表水平时遇到困难。报告的目标达成量表法的益处包括：1）解决了重要问题；2）患者参与并积极实现目标；3）一旦创建了量表，评估就很直接。不足之处包括：1）对老年人来说困难；2）对临床实践来说耗时且复杂。
结论
目标达成量表法在为社区居住老年人设定和评估目标方面显示出对临床实践和全科医疗研究的潜在益处。需要进一步研究以开发更标准化且耗时更少的目标达成量表法。
Zotero 插件