基层医疗卫生机构中患有多种疾病的多维体弱老年患者的医疗保健需求：一项定性研究。
The health care needs of multidimensional frail elderly patients with multimorbidity in primary health-care settings: a qualitative study.
作者信息
Zhao Linlin, Chang Bingjie, Hu Qinghua, Chen Xiaolei, Du Juan, Shao Shuang
机构信息
School of General Practice and Continuing Education, Capital Medical University, 10 You' anmen Outer West 1st Street, Beijing, 100069, China.
Department of general practice, Beijing Jishuitan Hospital, Capital Medical University, No. 31 Xinjiekou East Street, Beijing, 100035, China.
出版信息
BMC Prim Care. 2025 Apr 25;26(1):128. doi: 10.1186/s12875-025-02836-8.
PURPOSE
Our study aimed to explore the health care needs of older adults with multimorbidity assessed as multidimensional frailty from their perspective in Beijing, China, in primary health-care settings.
METHODS
This study was conducted using a qualitative approach involving semi-structured interviews of 21 participants at the Outpatient clinic, in four primary health care institutions (PHCIs), Beijing, China. The subjects were drawn from a cross-sectional survey that assessed multidimensional frailty in older adults with multimorbidity. The participants meeting the criteria were selected through purposive sampling until subject saturation. The interviews were transcribed and organized verbatim and then subjected to thematic analysis using inductive approach.
RESULTS
A total of four themes on the needs of the multidimensional frail elderly patients with multimorbidity were identified, including improving physical functioning, adjusting psychological status, obtaining social support, and choosing health care modalities. Improving physical functioning was their co-occurring need, regardless of the score on the physical frailty dimension. In contrast, it is when increased psychological and social frailty has an impact on physical functioning that might drive patients to develop psychological and social demands.
CONCLUSION
This exploratory study is helpful to understand the healthcare needs of the multidimensionally frail elderly patients with multimorbidity from the perspectives of individuals, families, and society, in turn formulate healthcare promotion strategies. Appropriate policies and measures should be taken, such as integrating multidimensional frailty assessments into current multimorbidity management protocols, developing personalized interventions centered on patient needs, conducting family function assessments and caregiver training programs, and enhancing the integration of social resources.
目的
我们的研究旨在从中国北京基层医疗卫生机构中患有多种疾病且被评估为多维虚弱的老年人的角度，探索他们的医疗保健需求。
方法
本研究采用定性研究方法，在中国北京的四家基层医疗卫生机构的门诊对21名参与者进行了半结构式访谈。研究对象来自一项评估患有多种疾病的老年人多维虚弱情况的横断面调查。通过目的抽样选取符合标准的参与者，直至达到主题饱和。访谈内容逐字转录并整理，然后采用归纳法进行主题分析。
结果
共确定了患有多种疾病的多维虚弱老年患者的四个需求主题，包括改善身体功能、调整心理状态、获得社会支持以及选择医疗保健方式。改善身体功能是他们共同的需求，无论身体虚弱维度的得分如何。相比之下，当心理和社会虚弱程度增加对身体功能产生影响时，可能会促使患者产生心理和社会需求。
结论
这项探索性研究有助于从个人、家庭和社会的角度了解患有多种疾病的多维虚弱老年患者的医疗保健需求，进而制定医疗保健促进策略。应采取适当的政策和措施，如将多维虚弱评估纳入当前的多种疾病管理方案，制定以患者需求为中心的个性化干预措施，开展家庭功能评估和护理人员培训项目，以及加强社会资源整合。
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