Department of Implementation Science, Division of Public Health Sciences, School of Medicine, Wake Forest University.
Center for Healthcare Innovation, School of Medicine, Wake Forest University.
N C Med J. 2024 Aug;85(5):358-366. doi: 10.18043/001c.121369.
There has been a growing interest in integrating social and function-focused care into health care settings. Little is known about what older adults perceive as the needs that impact their lives, and the resources to address patients' social and functional needs often exist outside of traditional health care settings.
Our objective was to understand frail older adults' and community organizations' perspectives on what social and functional needs impact older adults' health, the support they receive, and how organizations and health systems could partner to address these needs. We conducted semi-structured interviews with patients and community-based organizations. Patients were aged 65 years or older, frail (electronic frailty index greater than 0.21), and at an increased geographic risk of unmet social needs (Area Deprivation Index greater than or equal to the 75th percentile). Staff were from organizations that provided social and/or functional resources to older adults. We used an inductive content analysis approach and the constant comparative method to analyze the data and identify themes.
We interviewed 23 patients and 28 staff from 22 distinct organizations. We found that social, financial, and functional needs were common and highly intertwined among older adults with frailty, but the support they received at home, from their health care providers, and from community organizations was highly varied.
Our sample was limited to participants from one county, so the results may not be generalizable to other areas. We only inter-viewed organizations and patients with frailty.
Health systems and community organizations have distinct areas of expertise, and purposeful collaboration between them could be important in addressing the needs of frail older adults.
将社会和以功能为重点的护理融入医疗环境的做法越来越受到关注。对于影响老年人生活的需求以及解决患者社会和功能需求的资源，人们知之甚少，而这些资源通常存在于传统医疗保健环境之外。
我们的目的是了解体弱老年人和社区组织对影响老年人健康的社会和功能需求、他们所获得的支持，以及组织和卫生系统如何合作来满足这些需求的看法。我们对患者和社区组织的工作人员进行了半结构化访谈。患者年龄在 65 岁或以上，身体虚弱（电子衰弱指数大于 0.21），并且在社会需求得不到满足的地理风险较高（区域贫困指数大于或等于第 75 个百分位数）。工作人员来自为老年人提供社会和/或功能资源的组织。我们使用归纳内容分析方法和不断比较的方法来分析数据并确定主题。
我们采访了 23 名患者和 28 名来自 22 个不同组织的工作人员。我们发现，社会、经济和功能需求在体弱老年人中很常见且高度交织，但他们在家中、从医疗保健提供者和社区组织获得的支持却大相径庭。
我们的样本仅限于一个县的参与者，因此结果可能不适用于其他地区。我们只采访了有身体虚弱问题的组织和患者。
卫生系统和社区组织具有独特的专业知识，它们之间有针对性的合作对于满足体弱老年人的需求可能很重要。
