Department of Palliative Medicine, University of Cologne, Faculty of Medicine and Cologne University Hospital, Cologne, Germany.
Caring Community Cologne, Palliative and Hospice Network Cologne, Cologne, Germany.
Ann Palliat Med. 2024 Jul;13(4):778-790. doi: 10.21037/apm-23-598. Epub 2024 Jul 8.
Compassionate communities aim to empower people to deal with death, dying, and bereavement. They also intend to facilitate access to care and support at the end of life. However, there is a need for systematic knowledge on how to achieve the desired outcomes for citizens and for insights regarding the development, implementation, and evaluation. The aim of this study was to assess the views of members of a German Compassionate City, the "Caring Community Cologne" (CCC), and to report on its practical implementation.
The CCC consists of a citywide Round Table, a Steering Group, a Coordination Office and four Working Groups in areas where activities are already in place. We conducted two qualitative focus groups with nine members of three Working Groups. The transcripts were analysed with qualitative content analysis, using MAXQDA version 2022, and results were transferred into the logic model "Throughput Model".
At the time of evaluation, participants felt that the structures of the CCC were adequate, but criticised the cooperation and transparency between them. A key aspect of this was the requirement for a coordinating body. They stressed the support of federal institutions as a key factor, while at the same time describing insufficient citizen involvement. The transfer of the results into the Throughput Model highlighted four areas that the CCC should address: (I) neighbourhood networks need to be established to strengthen civic support; (II) people need to be made aware of the issues by making them accessible in their everyday lives; (III) the many existing support initiatives need to be better linked and made more accessible; (IV) adequate healthcare service structures have to be guaranteed.
The top-down approach described, supported by the city's engagement and involving existing initiatives can facilitate the development of a bottom-up civic engagement model in a large city. However, active citizen involvement appeared to be a challenge. The Throughput Model was a suitable basis for mapping work processes and developing evaluation plans.
富有同情心的社区旨在赋予人们应对死亡、临终和丧亲之痛的能力。它们还旨在促进临终关怀和支持的获取。然而，需要系统地了解如何为公民实现预期成果，并深入了解发展、实施和评估。本研究旨在评估德国富有同情心的城市“科隆关爱社区”（CCC）成员的观点，并报告其实践实施情况。
CCC 由一个全市范围的圆桌会议、一个指导小组、一个协调办公室和四个在已经开展活动的领域的工作组组成。我们对三个工作组的九名成员进行了两次定性焦点小组讨论。使用 MAXQDA 版本 2022 对转录本进行了定性内容分析，结果被转移到逻辑模型“吞吐量模型”中。
在评估时，参与者认为 CCC 的结构是足够的，但批评了它们之间的合作和透明度。这方面的一个关键因素是需要一个协调机构。他们强调联邦机构的支持是一个关键因素，同时也描述了公民参与不足。将结果转移到吞吐量模型中突出了 CCC 应该解决的四个领域：（I）需要建立邻里网络，以加强公民支持；（II）需要通过使其在日常生活中易于获取来提高人们对这些问题的认识；（III）需要更好地联系和使许多现有的支持举措更容易获得；（IV）必须保证提供充足的医疗保健服务结构。
这种自上而下的方法得到了城市参与和涉及现有举措的支持，可以促进在大城市发展自下而上的公民参与模式。然而，公民的积极参与似乎是一个挑战。吞吐量模型是映射工作流程和制定评估计划的合适基础。
