School of Nursing, Fudan University, Shanghai, China.
School of Nursing, Anhui University of Chinese Medicine, Anhui, Hefei, China.
Inquiry. 2024 Jan-Dec;61:469580241273177. doi: 10.1177/00469580241273177.
In response to the aging population, an integrated care policy has been put forward and implemented in China. The key aspect of this policy is the reform of services within long-term care facilities, representing a significant shift and innovation. This study aims to explore the perceptions and experiences of integrated care among older residents living in long-term care facilities. A descriptive qualitative design was applied in our study. Utilizing a purposive sampling method, 18 older adults from 5 long-term care institutions in Shanghai, China were selected. Data were collected through semi-structured in-depth interviews from October 2022 to April 2023, continuing until data saturation was reached. Directed content analysis was applied to analyze the interview data, guided by the Fundamentals of Care (FoC) Framework. Five themes and 11 subthemes were identified, including (1) Policy level: positive attitude and negative feelings. (2) Physiological level: satisfied basic daily life, primary medical services accessibility and chronic care management enhancement needed. (3) Psychological level: need for psychological support and need for self-perception recognition. (4) Relationship level: enhancement of humanistic care and need for a family atmosphere. (5) Social level: interpersonal communication constrained by the times and inadequate social engagement. Strengthening the awareness and participation of older people in the integrated care policy, and fully meeting the diverse needs including advanced medical care, chronic disease management, personalized life care, psychological support, humanistic care and social engagement will contribute to the improvement of the policy, so as to better adapt the demographic shift.
针对人口老龄化问题,中国提出并实施了综合护理政策。该政策的关键方面是长期护理机构内服务的改革,这代表着重大转变和创新。本研究旨在探讨长期护理机构中老年人对综合护理的看法和体验。本研究采用描述性定性设计。我们采用目的抽样法,从中国上海的 5 家长期护理机构中选择了 18 名年龄较大的成年人。数据收集于 2022 年 10 月至 2023 年 4 月,通过半结构化深入访谈进行,直至达到数据饱和。采用定向内容分析法,根据关怀基本原理(FoC)框架分析访谈数据。确定了五个主题和 11 个亚主题,包括(1)政策层面:积极的态度和消极的感受。(2)生理层面:满足基本日常生活,需要提高初级医疗服务的可及性和慢性病管理。(3)心理层面:需要心理支持和自我认知的认可。(4)关系层面:增强人文关怀和家庭氛围的需求。(5)社会层面:人际交往受到时代限制和社会参与不足。加强老年人对综合护理政策的认识和参与,并充分满足包括高级医疗、慢性病管理、个性化生活护理、心理支持、人文关怀和社会参与在内的多样化需求,将有助于改善政策,以更好地适应人口结构变化。