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患者相关因素在老年住院康复(GeRas)出院后多模式家庭康复干预实施中的作用:一项质性过程评估

The role of patient-related factors in the implementation of a multimodal home-based rehabilitation intervention after discharge from inpatient geriatric rehabilitation (GeRas): a qualitative process evaluation.

作者信息

Maier Leonie, Benzinger Petra, Abel Bastian, Roigk Patrick, Bongartz Martin, Wirth Isabel, Cuvelier Ingeborg, Schölch Sabine, Büchele Gisela, Deuster Oliver, Bauer Jürgen, Rapp Kilian, Ullrich Charlotte, Wensing Michel, Roth Catharina

机构信息

Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany.

Center for Geriatric Medicine, Heidelberg University Hospital, AGAPLESION Bethanien Hospital Heidelberg, Heidelberg, Germany.

出版信息

Eur Geriatr Med. 2024 Oct;15(5):1369-1382. doi: 10.1007/s41999-024-01027-5. Epub 2024 Jul 31.

Abstract

BACKGROUND

Structured aftercare programs are implemented to facilitate the transition from rehabilitation centers to patients' home environments. Taking the program GeRas as an example, this paper aims to evaluate the influence of patient-related factors on the implementation of the geriatric aftercare program GeRas from patients' and providers' perspectives.

METHODS

To capture patients' and providers' perspectives, qualitative interviews were conducted using a semi-structured interview guide. The analysis was inductive-deductive and based on the thematic analysis by Braun and Clarke and guided by Domain IV of the CFIR.

RESULTS

16 participants (10 patients, 4 providers, 2 family members) were interviewed from May 2023 to November 2023. Patient-related factors were perceived as an important aspect during the implementation of the GeRas program. The results were allocated to the four Constructs of Domain IV of the CFIR (Motivation, Opportunity, Capability, Needs). Especially patients' intrinsic motivation, social environment, and physical capabilities seemed to be crucial for successful implementation. While extrinsic motivation can mitigate missing personal capabilities, it cannot replace the presence of intrinsic motivation and capabilities. The results showed that patient-related factors are interlinked.

DISCUSSION/CONCLUSION: The relevance of patient-related factors during the implementation of the GeRas program shows that such programs must consider these factors during intervention planning.

摘要

背景

实施结构化的后续护理计划以促进从康复中心到患者家庭环境的过渡。以GeRas计划为例,本文旨在从患者和提供者的角度评估患者相关因素对老年后续护理计划GeRas实施的影响。

方法

为了了解患者和提供者的观点,使用半结构化访谈指南进行了定性访谈。分析采用归纳-演绎法,基于布劳恩和克拉克的主题分析,并以CFIR的第四领域为指导。

结果

2023年5月至2023年11月期间,共采访了16名参与者(10名患者、4名提供者、2名家庭成员)。患者相关因素被视为GeRas计划实施过程中的一个重要方面。结果被归入CFIR第四领域的四个构建要素(动机、机会、能力、需求)。特别是患者的内在动机、社会环境和身体能力似乎对成功实施至关重要。虽然外部动机可以弥补个人能力的不足,但它不能取代内在动机和能力的存在。结果表明,患者相关因素是相互关联的。

讨论/结论:GeRas计划实施过程中患者相关因素的相关性表明,此类计划在干预规划期间必须考虑这些因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d6f/11614932/a2ab2a67f37d/41999_2024_1027_Fig1_HTML.jpg

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