Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
PLoS One. 2024 Aug 26;19(8):e0307769. doi: 10.1371/journal.pone.0307769. eCollection 2024.
Individuals who experience a hip fracture have numerous care transitions. Improving the transition process is important for ensuring quality care; however, little is known about the priorities of different key interest groups. Our aim was to gather recommendations from these groups regarding care transitions for hip fracture.
We conducted a concept mapping study, inviting persons with lived experience (PWLE) who had a hip fracture, care partners, healthcare providers, and decision-makers to share their thoughts about 'what is needed to improve care transitions for hip fracture'. Individuals were subsequently asked to sort the generated statements into conceptual piles, and then rate by importance and priority using a five-point scale. Participants decided on the final map, rearranged statements, and assigned a name to each conceptual cluster.
A total of 35 participants took part in this concept mapping study, with some individuals participating in multiple steps. Participants included 22 healthcare providers, 7 care partners, 4 decision-makers, and 2 PWLE. The final map selected by participants was an 8-cluster map, with the following cluster labels: (1) access to inpatient services and supports across the care continuum (13 statements); (2) informed and collaborative discharge planning (13 statements); (3) access to transitional and outpatient services (3 statements); (4) communication, education and knowledge acquisition (9 statements); (5) support for care partners (2 statements); (6) person-centred care (13 statements); (7) physical, social, and cognitive activities and supports (13 statements); and (8) provider knowledge, skills, roles and behaviours (8 statements).
Our study findings highlight the importance of person-centred care, with active involvement of PWLE and their care partners throughout the care journey. Many participant statements included specific ideas related to continuity of care, and clinical knowledge and skills. This study provides insights for future interventions and quality improvement initiatives for enhancing transitions in care among hip fracture populations.
经历髋部骨折的个体有许多护理交接。改善交接过程对于确保高质量的护理至关重要；然而，对于不同关键利益相关群体的优先事项知之甚少。我们的目的是从这些群体中收集关于髋部骨折护理交接的建议。
我们进行了概念映射研究，邀请有髋部骨折经历的患者（PWLE）、护理伙伴、医疗保健提供者和决策者分享他们对“改善髋部骨折护理交接需要什么”的想法。随后，要求个人将生成的陈述归入概念堆，并使用五分制对重要性和优先级进行评分。参与者决定最终的图谱，重新排列陈述，并为每个概念集群分配一个名称。
共有 35 名参与者参与了这项概念映射研究，其中一些人参与了多个步骤。参与者包括 22 名医疗保健提供者、7 名护理伙伴、4 名决策者和 2 名 PWLE。参与者选择的最终图谱是一个 8 个聚类的图谱，以下是聚类标签：（1）在整个护理连续体中获得住院服务和支持（13 个陈述）；（2）知情和协作性出院计划（13 个陈述）；（3）获得过渡和门诊服务（3 个陈述）；（4）沟通、教育和知识获取（9 个陈述）；（5）照顾者的支持（2 个陈述）；（6）以人为本的护理（13 个陈述）；（7）身体、社会和认知活动和支持（13 个陈述）；（8）提供者的知识、技能、角色和行为（8 个陈述）。
我们的研究结果强调了以人为本的护理的重要性，让 PWLE 和他们的护理伙伴在整个护理过程中积极参与。许多参与者的陈述包括与连续性护理以及临床知识和技能相关的具体想法。这项研究为未来的干预措施和质量改进举措提供了思路，以改善髋部骨折人群的护理交接。
