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一种新型综合医疗保健模式的实施;支持有多种需求的老年人复杂居家护理的质量方面。

Implementation of a New Integrated Healthcare Model; Quality Aspects to Support the Complex Home Care of Older Adults with Multiple Needs.

作者信息

Gustafsson Lena-Karin, Anbacken Els-Marie, Östlund Gunnel, Bondesson Anna, Pettersson Tina, Zander Viktoria

机构信息

Division of Caring Science, School of Health, Care and Social Welfare, Mälardalens University, Eskilstuna, Sweden.

Division of Social Work, School of Health, Care and Social Welfare, Mälardalens University, Eskilstuna, Sweden.

出版信息

J Multidiscip Healthc. 2024 Jun 14;17:2879-2890. doi: 10.2147/JMDH.S455935. eCollection 2024.

Abstract

AIM

This study aims to describe experiences of the implementation of a new integrated healthcare model for older adults with complex care needs due to multimorbidity, living at home, from a health and welfare personnel perspective. The goal was to diminish hospitalization and still carry out high quality care at home for older adults living with multimorbidity. The model was implemented by two organizations working in cooperation, the municipality, and the region that handles interprofessional social care and healthcare in people's homes.

MATERIALS AND METHOD

Open-ended group interviews with personnel were carried out, three of the group interviews pre-implementations of the model, and three of the group interviews post-implementation. The interviews were audiotaped and analysed according to the procedure of thematic analysis.

RESULTS

The quality of the integrated care model was based on care-chain cooperation, shared professionalism, and creating relations with the patient including closeness to next of kin, which was underlined by the participants. Unencumbered time gave the professionals the possibility to develop quality in integrated healthcare as part of integrated and person-centred care. The coproduction of education, research interviews and the follow-up meeting identified successes in diminishing hospitalization rates according to the participants' experiences of the post-implementation interviews. An identified failure was, however, that shared professionalism was not developed over time, rather the different responsibilities were accentuated according to the information retrieved at the follow-up meeting.

CONCLUSION

Quality aspects of the model were identified in the present study. However, when implementation of a new model is completed, the organizations always have their own interpretation of how to further understand the model in question.

摘要

目的

本研究旨在从卫生和福利人员的角度,描述一种新的综合医疗模式在患有多种疾病、居家生活的老年人复杂护理需求中的实施经验。目标是减少住院率,同时仍为患有多种疾病的老年人在家中提供高质量护理。该模式由两个合作的组织实施,即负责家庭跨专业社会护理和医疗保健的市政府和地区。

材料与方法

对工作人员进行开放式小组访谈,在模式实施前进行了3次小组访谈,实施后进行了3次小组访谈。访谈进行了录音,并按照主题分析程序进行分析。

结果

综合护理模式的质量基于护理链合作、共享专业精神以及与患者建立关系,包括与近亲的亲近关系,参与者强调了这一点。不受干扰的时间使专业人员有可能在综合医疗保健中发展质量,作为综合和以患者为中心的护理的一部分。根据参与者在实施后访谈中的经验,教育、研究访谈和后续会议的共同成果确定了在降低住院率方面取得的成功。然而,一个确定的失败之处是,随着时间的推移,共享专业精神并未得到发展,而是根据后续会议获得的信息,不同的职责得到了强化。

结论

本研究确定了该模式的质量方面。然而,当一个新模型的实施完成后,各组织对于如何进一步理解该模型总是有自己的解读。

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Experiences of older adults in transition from hospital to community.老年人从医院过渡到社区的经历。
Can J Aging. 2015 Mar;34(1):90-9. doi: 10.1017/S0714980814000518. Epub 2014 Dec 30.

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