通过关键陪伴在养老院促进及时的综合姑息治疗：法国一项Padi-Palli干预研究的经验

Fostering timely integrated palliative care in nursing homes through critical companionship: experiences from a Padi-Palli interventional study in France.

作者信息

Bagaragaza Emmanuel, Umubyeyi Benoite, Leboul Danièle

机构信息

Département Recherche Enseignement Formation, Etablissements Jeanne Garnier, 106 avenue Émile Zola, Paris 75015, France.

Département Recherche Enseignement Formation, Etablissements Jeanne Garnier, Paris, France.

出版信息

Palliat Care Soc Pract. 2024 Nov 3;18:26323524241293819. doi: 10.1177/26323524241293819. eCollection 2024.

DOI:10.1177/26323524241293819

PMID:39498212

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11533194/

Abstract

BACKGROUND

One of the fundamental pillars of integrating a palliative approach in nursing home care is increasing professional competencies and institutional capacity. However, conventional training designs have been proven to fall short of supporting this integration. This paper details the results of a practice development intervention that used critical companionship as a learning design to facilitate the integration of a palliative approach in the care of nursing home residents in France.

OBJECTIVES

This study aimed to explore the perceived outcomes of Padi-Palli critical companionship in supporting the integration of a palliative approach in the care of residents in nursing homes in France.

DESIGN

Qualitative multiple case study situated within a constructivist theoretic lens.

METHODS

This qualitative multiple case study is part of a larger interventional mixed-method study. Nurses with palliative care clinical expertise facilitated experiential learning with nursing home professionals for 10 months spread across three phases. At the end of the intervention, a purposive sampling method was used to select professionals from six nursing homes that participated, including leaders and critical companions. Focus groups and individual interviews were used to collect data between February 2023 and March 2024. Data analysis followed Braun and Clarke's reflexive thematic analysis.

RESULTS

Four interrelated themes explained how Padi-Palli critical companionship enhanced the palliative care competencies of professionals, improved nursing home palliative care practices, supported organisational practices for palliative care and facilitated collaborative learning at the bedside. The collaborative and co-creative principles that informed the delivery of the Padi-Palli critical companionship program facilitated a culture shift towards integrating a palliative approach in resident care at individual, team and organisational levels.

CONCLUSION

Critical companionship offers an innovative practice development approach that can support the delivery of timely palliative care for residents in nursing homes.

TRIAL REGISTRATION

ID-RCB 2020-A01832-37.

摘要

背景

将姑息治疗方法融入养老院护理的一个基本支柱是提高专业能力和机构能力。然而，事实证明，传统的培训设计不足以支持这种融合。本文详细介绍了一项实践发展干预措施的结果，该措施采用关键陪伴作为学习设计，以促进在法国养老院居民护理中融入姑息治疗方法。

目的

本研究旨在探讨帕迪 - 帕利关键陪伴在支持法国养老院居民护理中融入姑息治疗方法方面的感知结果。

设计

基于建构主义理论视角的定性多案例研究。

方法

这项定性多案例研究是一项更大的干预性混合方法研究的一部分。具有姑息治疗临床专业知识的护士为养老院专业人员提供了为期10个月、分三个阶段的体验式学习。干预结束时，采用目的抽样方法从参与的六家养老院中挑选专业人员，包括负责人和关键陪伴者。在2023年2月至2024年3月期间，通过焦点小组和个人访谈收集数据。数据分析采用布劳恩和克拉克的反思性主题分析法。