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探索印度尼西亚雅加达养老院多学科协作的实施情况:一项描述性现象学研究。

Exploring the implementation of multidisciplinary collaboration at nursing homes in Jakarta, Indonesia: A descriptive phenomenological study.

作者信息

Hamid Achir Yani S, Rekawati Etty, Darmawan Ede Surya

机构信息

Faculty of Nursing, Universitas Indonesia, Depok, West Java, Indonesia.

Sekolah Tinggi Ilmu Kesehatan Banten, Banten, Indonesia.

出版信息

Belitung Nurs J. 2024 Jun 28;10(3):332-340. doi: 10.33546/bnj.3226. eCollection 2024.

Abstract

BACKGROUND

A well-functioning multidisciplinary team optimizes resource utilization and reduces care redundancy, fragmentation, and wastage. Collaborative efforts yield a clearer understanding of older people's needs and desires, significantly reducing hospitalization days. Despite limited studies, particularly in Indonesia, investigating professionals' experiences in implementing multidisciplinary collaboration in government nursing homes, nursing care quality remains a concern.

OBJECTIVE

This study aimed to explore the implementation of multidisciplinary collaboration in nursing homes from the perspectives of various disciplines.

METHODS

A descriptive phenomenological study was used with semi-structured interviews and focus group discussions with multidisciplinary care providers, including nurses, doctors, social workers, physiotherapists, psychologists, occupational and recreational activity instructors, and clergy in nursing homes owned by the Jakarta provincial government. A total of 64 participants were involved, and data were collected from September 2022 to July 2023. Data were analyzed using content-based analysis.

RESULTS

Three main themes emerged: 1) context of multiple collaborations, 2) barriers to implementing multiple collaborations, and 3) impacts of non-optimal multidisciplinary collaborations. Nursing home management's multidisciplinary teams predominantly implement professional-centered care with limited support systems. While providers generally perceive collaboration positively, shared responsibility and joint work among professionals are lacking.

CONCLUSION

This study highlights the need to improve multidisciplinary collaboration in nursing homes to enhance care quality for older individuals. While providers view collaboration positively, barriers like a lack of shared responsibility and joint work persist. Enhancing teamwork cohesion through improved communication and integrated case reporting systems is crucial. Addressing human resource and systemic barriers is also vital. By overcoming these challenges, nursing homes can optimize resource use, reduce care redundancy, and better meet the diverse needs of older residents.

摘要

背景

一个运作良好的多学科团队能够优化资源利用,减少护理冗余、碎片化和浪费现象。协作努力能更清晰地了解老年人的需求和愿望,显著减少住院天数。尽管相关研究有限,尤其是在印度尼西亚,对政府养老院中专业人员实施多学科协作的经验进行调查后发现,护理质量仍是一个令人担忧的问题。

目的

本研究旨在从不同学科的角度探讨养老院中多学科协作的实施情况。

方法

采用描述性现象学研究方法,对包括护士、医生、社会工作者、物理治疗师、心理学家、职业和娱乐活动指导员以及雅加达省政府所属养老院的神职人员在内的多学科护理提供者进行半结构化访谈和焦点小组讨论。共有64名参与者,数据收集时间为2022年9月至2023年7月。采用基于内容的分析方法对数据进行分析。

结果

出现了三个主要主题:1)多重协作的背景;2)实施多重协作的障碍;3)非最佳多学科协作的影响。养老院管理部门的多学科团队主要实施以专业为中心的护理,支持系统有限。虽然提供者总体上对协作持积极看法,但专业人员之间缺乏共同责任和联合工作。

结论

本研究强调需要改善养老院中的多学科协作,以提高对老年人的护理质量。虽然提供者对协作持积极看法,但缺乏共同责任和联合工作等障碍仍然存在。通过改善沟通和整合病例报告系统来增强团队凝聚力至关重要。解决人力资源和系统障碍也至关重要。通过克服这些挑战,养老院可以优化资源利用,减少护理冗余,并更好地满足老年居民的多样化需求。

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