Gao Yurun, Yang Yutong, Qin Tingting, Li Xingming, Guo Junjun, Zhou Lihan, Gu Mingyu, Wang Yao
School of Public Health, Capital Medical University, Beijing, People's Republic of China.
J Multidiscip Healthc. 2025 Apr 24;18:2293-2304. doi: 10.2147/JMDH.S514336. eCollection 2025.
As the population ages, the growing demand for elderly care has become a multi-faceted issue, encompassing the health of individuals, the viability of healthcare systems in addition to family and societal pressure. This study aims to identify the associated factors and provide recommendations to inform the better implementation of home health care services in Beijing.
This study was a qualitative study in which 13 individuals were selected for focus group interviews through purposive sampling to understand the current status of home-based health care service provided by Beijing's community health service organizations, and to categorize facilitating and barriers factors into the five domains of the Consolidated Framework for Implementation Research (CFIR), a comprehensive framework for implementation research, and to derive targeted recommendations by using the expert recommendations for implementing change (ERIC).
Of the 13 study participants, 4 (30.77%) were physicians, 9 (69.23%), were nurses and 8 (61.54%) were involved in the management of home-based health care service. The main facilitators included Intervention Source, Evidence Strength and Quality, and Adaptability; Local Attitudes, Conditions, and Cosmopolitanism; Relationship Connection, Incentive System; and Motivation. Major barriers identified included Design Quality and Packaging, Cosmopolitanism, Peer Pressure, Available Resources, Structural Characteristics, Access to knowledge and information, Key Stakeholders, and Planning. To address the barrier factors, CFIR-ERIC matching tool was utilized to make recommendations. Importance was determined by cumulative selection rate, resulting in multiple improvement strategies.
The provision of home-based health care service by Beijing's community health service organizations meets some of the needs of participants in this study reported, but there are still some barriers that can be further improved with reference to the ERIC recommendations.
随着人口老龄化，对老年护理的需求不断增长已成为一个多方面的问题，涉及个人健康、医疗保健系统的可行性以及家庭和社会压力。本研究旨在确定相关因素，并提出建议，以促进北京居家医疗服务的更好实施。
本研究为定性研究，通过目的抽样选取13人进行焦点小组访谈，以了解北京社区卫生服务机构提供的居家医疗服务现状，并将促进因素和障碍因素归类到实施研究综合框架（CFIR）的五个领域（CFIR是一个全面的实施研究框架），并使用实施变革的专家建议（ERIC）得出针对性建议。
13名研究参与者中，4名（30.77%）为医生，9名（69.23%）为护士，8名（61.54%）参与居家医疗服务管理。主要促进因素包括干预源、证据强度和质量以及适应性；当地态度、条件和国际化；关系连接、激励系统；以及动机。确定的主要障碍包括设计质量和包装、国际化、同伴压力、可用资源、结构特征、知识和信息获取、关键利益相关者以及规划。为解决障碍因素，利用CFIR-ERIC匹配工具提出建议。重要性由累积选择率确定，从而产生多种改进策略。
北京社区卫生服务机构提供的居家医疗服务满足了本研究中部分参与者报告的需求，但仍存在一些障碍，可参考ERIC建议进一步改进。
