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专业人士对社区护理中再能力干预计划实施的看法的定性探索。

A qualitative exploration of professionals' perspectives on the implementation of reablement intervention programs in community care.

机构信息

Department of Health Services Research, Faculty of Health Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.

Living Lab of Ageing and Long Term Care, Maastricht, The Netherlands.

出版信息

Sci Rep. 2024 May 18;14(1):11391. doi: 10.1038/s41598-024-62047-6.

Abstract

Reablement is considered a complex intervention due to its multicomponent, person-centered, holistic approach promoting older adults' active participation in daily activities. It is important to consider the unique context in which complex interventions are implemented, as contextual factors may interact and influence implementation outcomes. As part of the European TRANS-SENIOR project, this qualitative study aimed to gain insight into professionals' experiences with reablement implementation in Dutch community care. Using the Consolidated Framework for Implementation Research, four focus groups were conducted comprising 32 professionals. Two groups were formed: one at operational level, including therapists, nursing staff, social workers, and domestic support; and one at organizational/strategic level, including project leaders, managers, directors, municipality representatives and health insurers. Participating care organizations had at least 6 months of experience with deploying and implementing reablement. Findings reflected three themes: (1) strength of interdisciplinary collaboration; highlighting significance of sharing goals and beliefs, (2) integrating the reablement philosophy into the organization; underscoring managements role in fostering support across all organizational layers, and (3) achieving a culture change in the healthcare system; emphasizing current funding models impeding value-based care tailored to the individual's goals and needs. The results offer valuable insights for implementation of complex interventions, like reablement.

摘要

康复是一种复杂的干预措施,因为它具有多组分、以个人为中心、整体的方法,可以促进老年人积极参与日常活动。考虑到复杂干预措施实施的独特背景非常重要,因为背景因素可能会相互作用并影响实施结果。作为欧洲 TRANS-SENIOR 项目的一部分,这项定性研究旨在深入了解荷兰社区护理中专业人员实施康复的经验。本研究使用实施研究综合框架,进行了四个焦点小组,共有 32 名专业人员参加。两个小组分别是:一个在运营层面,包括治疗师、护理人员、社会工作者和家庭支持人员;另一个在组织/战略层面,包括项目负责人、管理人员、主任、市代表和健康保险公司。参与的护理组织至少有 6 个月的部署和实施康复的经验。研究结果反映了三个主题:(1)跨学科合作的力量;强调分享目标和信念的重要性,(2)将康复理念融入组织;强调管理层在促进所有组织层面的支持方面的作用,以及(3)在医疗保健系统中实现文化变革;强调当前的资金模式阻碍了基于价值的护理,这种护理模式是根据个人的目标和需求定制的。研究结果为康复等复杂干预措施的实施提供了有价值的见解。

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本文引用的文献

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Bad to All? A Novel Way to Analyze the Effects of Fee-for-Service on Multiple Grades Hospitals Operation Outcomes.
Int J Environ Res Public Health. 2021 Dec 2;18(23):12723. doi: 10.3390/ijerph182312723.

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