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消费者对新型数字衰弱教育课程“关注衰弱”设计的看法:一项定性协同设计研究

Consumers' Perspectives on the Design of a New Digital Frailty Education Course, 'Focus on Frailty': A Qualitative Co-Design Study.

作者信息

Ludlow Kristiana, Logan Benignus, Arora Jhalak, Martin Sarah, Miller Elizabeth, Hubbard Ruth E, Warren Nicola, Gallagher Olivia, Saunders Rosemary

机构信息

Centre for Health Services Research, The University of Queensland, Brisbane, Australia.

Australian Frailty Network, Brisbane, Australia.

出版信息

Health Expect. 2025 Jun;28(3):e70287. doi: 10.1111/hex.70287.

Abstract

INTRODUCTION

Frailty-focused care in hospitals is hindered by systemic barriers, ageism and stereotypes about older adults and frailty. There is a need for frailty education to increase healthcare professionals' and students' understanding of frailty.

OBJECTIVE

As part of a larger study to co-design a new digital frailty education course, 'Focus on Frailty', this study aimed to explore consumers' and caregivers' perspectives on (i) how frailty and older adults should be represented in frailty education and (ii) what healthcare professionals should be taught about caring for older adults and people who are frail in hospitals.

DESIGN

This was a qualitative co-design study.

SETTING AND PARTICIPANTS

Participants (n = 25) were older Australians, people living with frailty and family caregivers (collectively, 'consumers') who had interacted with the hospital system. This study was conducted in Australia via Zoom and telephone.

METHODS

Participants engaged in focus groups or individual interviews and completed a demographic questionnaire and a Research Engagement Feedback Survey. Qualitative data were inductively analysed using template analysis (codebook thematic analysis). Quantitative demographic data were analysed using descriptive statistics.

RESULTS

Seven themes were identified: (1) Consumers' understanding of frailty as loss, deterioration and vulnerability; (2) Utilise a holistic approach to frailty care; (3) Dispel stereotypes; (4) Value consumers' lived experience expertise; (5) Include diverse representation and educate for diversity; (6) Promote meaningful interactions; and (7) Practice care coordination.

DISCUSSION

Participants acknowledged the multifaceted nature of frailty, advocating for holistic frailty education that considers physical, social, emotional, cognitive, financial and spiritual aspects. They described the importance of representing real-world scenarios and stories, images and videos of real people that reflected the diversity of lived experience. Participants wanted 'Focus on Frailty' to include education on individualised care; looking beyond the acute situation; multidisciplinary care coordination that involved informal caregivers; overcoming stereotypes and ageism; and meaningfully interacting with older adults and people who are frail.

CONCLUSIONS

Consumers wanted to be represented in frailty education in a way that elevates lived experience and celebrates diversity. They expressed that healthcare professionals should be taught to avoid stereotypes, coordinate multidisciplinary care and engage in meaningful interactions with patients. Consumer-focused recommendations for designing frailty education were generated.

PATIENT OR PUBLIC CONTRIBUTION

E.M., a consumer partner, contributed to the study design, focus group/interview guide, ethics application and participant information and consent forms. E.M. attended some of the focus groups and contributed to the interpretation of study findings. She also contributed to manuscript revisions. Twenty-five consumers (family caregivers, older adults and people with lived experience of frailty) participated in focus groups and interviews. Participants shared their perspectives on frailty and contributed to the co-design of a new digital frailty education course for healthcare professionals and students.

摘要

引言

医院中以衰弱为重点的护理受到系统性障碍、年龄歧视以及对老年人和衰弱的刻板印象的阻碍。需要开展衰弱教育,以提高医护人员和学生对衰弱的理解。

目的

作为一项共同设计新的数字衰弱教育课程“关注衰弱”的大型研究的一部分,本研究旨在探讨消费者和护理人员对于(i)在衰弱教育中应如何呈现衰弱和老年人,以及(ii)应教导医护人员如何在医院护理老年人和衰弱者的看法。

设计

这是一项定性的共同设计研究。

背景与参与者

参与者(n = 25)为与医院系统有过接触的澳大利亚老年人、衰弱者及家庭护理人员(统称为“消费者”)。本研究通过Zoom和电话在澳大利亚进行。

方法

参与者参加焦点小组或个人访谈,并完成一份人口统计问卷和一份研究参与反馈调查。定性数据采用模板分析(编码本主题分析)进行归纳分析。定量人口统计数据采用描述性统计进行分析。

结果

确定了七个主题:(1)消费者对衰弱的理解为丧失、恶化和脆弱性;(2)采用整体方法进行衰弱护理;(3)消除刻板印象;(4)重视消费者的生活经验专长;(5)纳入多样化的呈现并开展多样性教育;(6)促进有意义的互动;(7)实施护理协调。

讨论

参与者认识到衰弱的多面性,主张开展全面的衰弱教育,涵盖身体、社会、情感、认知、财务和精神等方面。他们描述了呈现反映生活经历多样性的真实场景、真实人物的故事、图像和视频的重要性。参与者希望“关注衰弱”课程包括个性化护理教育;超越急性病情况;涉及非正式护理人员的多学科护理协调;克服刻板印象和年龄歧视;以及与老年人和衰弱者进行有意义的互动。

结论

消费者希望在衰弱教育中以提升生活经验和颂扬多样性的方式得到呈现。他们表示应教导医护人员避免刻板印象、协调多学科护理并与患者进行有意义的互动。生成了以消费者为中心的衰弱教育设计建议。

患者或公众贡献

消费者合作伙伴E.M. 参与了研究设计、焦点小组/访谈指南、伦理申请以及参与者信息和同意书的制定。E.M. 参加了部分焦点小组,并参与了研究结果的解读。她还参与了稿件修订。25名消费者(家庭护理人员、老年人和有衰弱生活经历的人)参加了焦点小组和访谈。参与者分享了他们对衰弱的看法,并为医护人员和学生共同设计一门新的数字衰弱教育课程做出了贡献。

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