Johnson Hannah, Simons Megan, Newcomb Dana, Borkoles Erika
Integrated Care, Children's Health Queensland Hospital and Health Service, Level 9, Centre for Children's Health Research, South Brisbane QLD, AU.
Department of Occupational Therapy, Queensland Children's Hospital, South Brisbane QLD, AU.
Int J Integr Care. 2020 Oct 27;20(4):7. doi: 10.5334/ijic.5545.
Benefits of integrated care include improved health outcomes and more satisfaction with experiences of care for consumers. For children and young people with chronic and complex health conditions, their care may be fragmented due to the multitude of healthcare providers involved. This paper describes the experiences of integrated care in a paediatric tertiary hospital.
Using an Interpretive Phenomenological Analysis approach, semi-structured interviews were conducted with children and young people, their parents and healthcare providers to explore stakeholders' integrated care experiences.
Nineteen interviews were completed (6 children and young people, 7 parents and 6 healthcare providers) and transcribed verbatim. Two recurrent themes were applicable across the three cohorts: 'agency and empowerment' and 'impact of organisational systems, supports and structures'.
Stakeholders' experiences of integrated care highlighted the need to examine the discrepancies between healthcare strategies, policies and service delivery within a complex, and often inflexible organisational structure. Power imbalance and family agency (including directly with children and young people) needs to be addressed to support the implementation of integrated care.
综合护理的益处包括改善健康状况以及提高消费者对护理体验的满意度。对于患有慢性和复杂健康问题的儿童和年轻人来说,由于涉及众多医疗服务提供者,他们的护理可能会变得零散。本文描述了一家儿科三级医院的综合护理体验。
采用解释现象学分析方法,对儿童和年轻人、他们的父母以及医疗服务提供者进行半结构化访谈,以探索利益相关者的综合护理体验。
完成了19次访谈(6名儿童和年轻人、7名父母和6名医疗服务提供者),并逐字转录。两个反复出现的主题适用于这三个群体:“能动性与赋权”以及“组织系统、支持和结构的影响”。
利益相关者的综合护理体验凸显了在复杂且往往缺乏灵活性的组织结构中,审视医疗保健策略、政策与服务提供之间差异的必要性。需要解决权力不平衡和家庭能动性(包括直接与儿童和年轻人相关的能动性)问题,以支持综合护理的实施。