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在荷兰背景下定义康复:一项改良德尔菲研究。

Defining Reablement in the Dutch Context: A Modified Delphi Study.

作者信息

Buma Lise Elisabeth, Mouchaers Ines, Zwakhalen Sandra M G, Vluggen Stan, Satink Ton, Metzelthin Silke F

机构信息

Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands.

Living Laboratory in Ageing and Long-Term Care, Maastricht, the Netherlands.

出版信息

J Multidiscip Healthc. 2025 May 23;18:2859-2873. doi: 10.2147/JMDH.S522161. eCollection 2025.

Abstract

INTRODUCTION

For the past decade, the Netherlands has been developing and implementing reablement programs to promote independence and to empower older adults' autonomy. However, a key challenge remains the lack of clarity around the definition of reablement and its relations to usual care practices. Existing international definitions lack specificity to account for contextual differences, such as variations in healthcare systems and cultural norms. An operational definition is needed that not only fits the Dutch health and social care system and incorporates context-specific elements. This study extends the original conceptual definition by integrating these elements, offering clearer, more practical guidance for real-world application.

MATERIALS AND METHODS

A modified Delphi study was performed to develop a definition of reablement that fits the Dutch health and social care system, extending beyond conceptual understanding. The study comprised three expert rounds and three Delphi survey rounds.

RESULTS

A total of 139 participants from Dutch health and social care, education, research, and representatives of clients and informal caregivers, participated. They evaluated statements in four sections: the target group, aims, type of care or support, and characteristics of reablement programs. Key discussions during the expert rounds focused mainly on 1) the target group, emphasizing the importance of involving individuals and their families, and 2) the characteristics of reablement, such as coordinating roles, team composition, and size. Input from the Delphi surveys and expert rounds led to the development of an operational definition for the Dutch context, agreed upon by 81% of stakeholders.

CONCLUSION

The Delphi methodology proved valuable in identifying context-specific elements and incorporating expert perspectives, creating a culturally and contextually sensitive definition. This definition distinguishes itself from the international version by offering practical guidance on areas of application and interventions, with a focus on promoting social participation, well-being, and the involvement of the individual's social network.

摘要

引言

在过去十年中,荷兰一直在制定和实施康复计划,以促进老年人的独立性并增强其自主性。然而,一个关键挑战仍然是康复的定义及其与常规护理实践的关系缺乏明确性。现有的国际定义缺乏具体性,无法考虑到背景差异,例如医疗保健系统和文化规范的差异。需要一个不仅适用于荷兰卫生和社会护理系统,而且纳入特定背景要素的操作性定义。本研究通过整合这些要素扩展了最初的概念定义,为实际应用提供了更清晰、更实用的指导。

材料与方法

进行了一项改良的德尔菲研究,以制定一个适用于荷兰卫生和社会护理系统的康复定义,超越概念理解。该研究包括三轮专家咨询和三轮德尔菲调查。

结果

共有来自荷兰卫生和社会护理、教育、研究领域的139名参与者以及服务对象和非正式照护者的代表参与其中。他们对四个部分的陈述进行了评估:目标群体、目标、护理或支持类型以及康复计划的特点。专家咨询过程中的关键讨论主要集中在:1)目标群体,强调个人及其家庭参与的重要性;2)康复的特点,如协调角色、团队组成和规模。德尔菲调查和专家咨询的意见促使形成了一个适用于荷兰背景的操作性定义,81%的利益相关者达成了一致。

结论

德尔菲方法在识别特定背景要素和纳入专家观点方面被证明是有价值的,从而创建了一个对文化和背景敏感的定义。这个定义通过在应用领域和干预措施方面提供实用指导,与国际版本有所不同,重点是促进社会参与、福祉以及个人社交网络的参与。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5344/12118488/9e194016a8d7/JMDH-18-2859-g0001.jpg

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