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“居家养老,而非养老院养老”——提高接受短期护理的老年人的护理质量:一项以个人为中心、资源导向型项目的开发

'Home, Instead of Nursing Home'-Improving the Quality of Care for Older People Receiving Short-Term Care: Development of a Person-Centred, Resource-Oriented Programme.

作者信息

Brenner Rouven, Kohler Myrta, Rohner Shauna L, Gattinger Heidrun

机构信息

School of Health Sciences, Institute of Applied Nursing Sciences, Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland.

出版信息

Int J Older People Nurs. 2025 Mar;20(2):e70020. doi: 10.1111/opn.70020.

Abstract

INTRODUCTION

Worldwide, healthcare systems continue to evolve approaches to acute care delivery for older people. The Swiss healthcare system, for example, utilises Diagnosis-Related Groups (Swiss DRG) to structure hospital stays. This system creates opportunities to enhance post-acute care services that support functional recovery and independence. The 'Home, Instead of Nursing Home' project collaboratively developed an integrated programme that combines staff education with structured care delivery processes to enhance person-centred, rehabilitative care for older people in acute transitional care, emphasising autonomy and quality of life.

METHODS

The development process consisted of four steps: inter-professional workshops with healthcare professionals, interviews with residents of nursing homes providing acute transitional care and their relatives, data synthesis and programme development. Participants (N = 38) were individuals from three nursing homes, including healthcare professionals, residents and relatives. We conducted a thematic analysis to identify essential workshop and interview themes.

RESULTS

The analysis identified four main themes: promoting a person-centred, resource-oriented culture; implementing person-centred, resource-oriented care; fostering movement competence and developing a champion role. The derived programme for person-centred and resource-oriented care (PCC&ROC) consists of four pillars: PCC&ROC care culture, PCC&ROC care planning, movement promotion and coaching and consulting. We adapted the programme to the individual circumstances of the three nursing homes.

CONCLUSION

The programme integrates international best practices with a salutogenic perspective and the inclusion of residents and their relatives. It addresses the critical need for person-centred and resource-oriented care in the context of nursing home short-term care for older individuals, promoting autonomy and improving their quality of life. This research emphasises the importance of involving relevant stakeholders in evidence-based programme development to develop a programme tailored to the needs and challenges of the intended population.

摘要

引言

在全球范围内,医疗保健系统不断发展针对老年人的急性护理服务方式。例如,瑞士医疗保健系统利用诊断相关分组(瑞士诊断相关分组)来安排住院时间。该系统为加强支持功能恢复和独立的急性后护理服务创造了机会。“居家而非养老院”项目联合开发了一个综合项目,将员工教育与结构化护理流程相结合,以加强针对急性过渡护理中老年人的以人为本的康复护理,强调自主性和生活质量。

方法

开发过程包括四个步骤:与医疗保健专业人员举行跨专业研讨会、采访提供急性过渡护理的养老院居民及其亲属、数据综合和项目开发。参与者(N = 38)来自三家养老院,包括医疗保健专业人员、居民和亲属。我们进行了主题分析,以确定研讨会和访谈的关键主题。

结果

分析确定了四个主要主题:促进以人为本、资源导向的文化;实施以人为本、资源导向的护理;培养运动能力和发挥倡导者作用。以人为本和资源导向护理(PCC&ROC)的衍生项目包括四个支柱:PCC&ROC护理文化、PCC&ROC护理规划、运动促进以及指导和咨询。我们根据三家养老院的具体情况对该项目进行了调整。

结论

该项目将国际最佳实践与健康生成视角以及居民及其亲属的参与相结合。它满足了在养老院对老年人进行短期护理的背景下对以人为本和资源导向护理的迫切需求,促进了自主性并改善了他们的生活质量。这项研究强调了让相关利益攸关方参与循证项目开发以制定符合目标人群需求和挑战的项目的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b86/11889476/cb42900db9a6/OPN-20-e70020-g001.jpg

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