Towsley Gail L, Edelman Linda S, Geurin Roxanne
University of Utah College of Nursing, Salt Lake City, UT, USA.
University of Utah College of Nursing, Salt Lake City, UT, USA.
J Am Med Dir Assoc. 2025 Apr;26(4):105504. doi: 10.1016/j.jamda.2025.105504. Epub 2025 Mar 3.
The objective of this study was to identify best practices for nursing home (NH) virtual care conferences using Me & My Wishes-videos that document care preferences of residents, including those living with Alzheimer's disease and related dementias. Videos are shared during care conferences with care partners and staff to ensure that the care provided aligns with the resident's wishes, especially as they approach the end of life.
A qualitative descriptive design involving focus groups providing the perspective of 3 groups (people living with dementia, NH staff, and care partners) was used to determine what makes a successful care conference when the care conference is conducted virtually.
Convenience sampling was used to recruit focus group participants (ie, community advisors) from various geographic locations. Recruitment was facilitated through established relationships with community partner groups. Advisors included NH leaders, community-dwelling older adults, and care partners.
Six virtual focus group sessions were conducted from February to June 2023. A semistructured guide was used to identify key factors of successful virtual care conferences when using the Me & My Wishes intervention. Sessions were recorded, transcribed, and analyzed using content analysis.
Three domains for successful virtual care conferences were identified. They are resident-driven, engaging, and structured. They include interdisciplinary care team members most familiar with the resident, prioritize the needs and preferences of residents to ensure they are central to the discussion, and encourage active participation of residents and care partners. Finally, care conferences are led by trained facilitators, with the entire interdisciplinary care team receiving training on conducting and participating in care conferences, including providing technology support to maximize resident and care partner engagement.
Successful care conferences, whether in-person or virtual, require structured approaches that prioritize resident involvement and include people who know the resident best.
本研究的目的是确定养老院（NH）使用“我和我的愿望”视频进行虚拟护理会议的最佳实践方法，这些视频记录了居民（包括患有阿尔茨海默病及相关痴呆症的居民）的护理偏好。在护理会议期间，这些视频会与护理伙伴和工作人员分享，以确保所提供的护理符合居民的意愿，尤其是在他们接近生命末期时。
采用定性描述性设计，通过焦点小组提供三组人员（痴呆症患者、养老院工作人员和护理伙伴）的观点，以确定在进行虚拟护理会议时，成功的护理会议的要素。
采用便利抽样的方法，从不同地理位置招募焦点小组参与者（即社区顾问）。通过与社区合作伙伴团体建立的关系来促进招募工作。顾问包括养老院领导、居住在社区的老年人和护理伙伴。
2023年2月至6月进行了六次虚拟焦点小组会议。使用半结构化指南来确定使用“我和我的愿望”干预措施时成功的虚拟护理会议的关键因素。会议进行了录音、转录，并采用内容分析法进行分析。
确定了成功的虚拟护理会议的三个领域。它们是居民主导、引人入胜和结构化。这包括最熟悉居民的跨学科护理团队成员，优先考虑居民的需求和偏好，以确保他们是讨论的核心，并鼓励居民和护理伙伴积极参与。最后，护理会议由经过培训的主持人主持，整个跨学科护理团队都接受了关于主持和参与护理会议的培训，包括提供技术支持，以最大限度地提高居民和护理伙伴的参与度。
成功的护理会议，无论是面对面还是虚拟形式，都需要结构化的方法，优先考虑居民的参与，并包括最了解居民的人员。
