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针对早期痴呆症患者的基层医疗诊所协作护理模式:日本基层医疗医生的横断面调查

Collaborative Care Models of Primary Care Clinics for People with Early-Stage Dementia: A Cross-Sectional Survey of Primary Care Physicians in Japan.

作者信息

Tsuda Shuji, Toya Junichiro, Ito Kae

机构信息

Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi, Tokyo 173-0015, Japan.

Sakurashinmachi Urban Clinic, 3-21-1-2F Shinmachi, Setagaya, Tokyo 154-0014, Japan.

出版信息

Int J Integr Care. 2024 Jun 3;24(2):21. doi: 10.5334/ijic.7726. eCollection 2024 Apr-Jun.

Abstract

OBJECTIVES

This study explored collaboration models between primary care physicians (PCPs) and care managers (CMs) and assessed each model's potential in meeting the support needs of individuals with early-stage dementia.

METHODS

In 2022, a cross-sectional survey was conducted among the PCPs in Tokyo. The data regarding the participant and clinic characteristics and daily practices for individuals with early-stage dementia were collected. The clinical collaborative practice was classified using a latent class analysis; comparisons were made between the identified classes based on 14 items in seven domains of support.

RESULTS

Two collaborative and one stand-alone models were identified. The former varied in the professionals' roles, with one led by PCPs and the other by CMs. We named them PCP-led, CM-led, and stand-alone models, accounting for 46.4%, 32.8%, and 20.6% of the clinics, respectively. The PCP-led clinics were significantly more likely to provide support than the stand-alone ones across five domains: cognitive function, care planning, carers' support, information, and social health. The CM-led model clinics generally fell between those of the other two models.

CONCLUSION

Different leadership styles exist in the PCP-CM collaborations in care delivery for people with early-stage dementia. This collaboration offers distinct advantages for clinics in addressing their needs.

摘要

目的

本研究探讨了初级保健医生(PCP)与护理经理(CM)之间的协作模式,并评估了每种模式在满足早期痴呆症患者支持需求方面的潜力。

方法

2022年,对东京的初级保健医生进行了横断面调查。收集了参与者和诊所的特征以及早期痴呆症患者的日常实践数据。使用潜在类别分析对临床协作实践进行分类;根据七个支持领域的14项内容,对确定的类别进行比较。

结果

确定了两种协作模式和一种独立模式。前者在专业人员的角色上有所不同,一种由初级保健医生主导,另一种由护理经理主导。我们将它们命名为初级保健医生主导模式、护理经理主导模式和独立模式,分别占诊所的46.4%、32.8%和20.6%。在认知功能、护理计划、照顾者支持、信息和社会健康这五个领域,初级保健医生主导的诊所比独立诊所更有可能提供支持。护理经理主导模式的诊所通常介于其他两种模式之间。

结论

在为早期痴呆症患者提供护理服务时,初级保健医生与护理经理的合作存在不同的领导风格。这种合作为诊所满足患者需求提供了明显的优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8725/11160391/ca18850284da/ijic-24-2-7726-g1.jpg

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