一般实践中的连续性的当代本体学:在数字时代捕捉其多重本质
Emma Ladds1, Trisha Greenhalgh1, Richard Byng2
1Nuffield Department of Primary Care Health Sciences, University of Oxford, UK.
Social science & medicine (1982)
|August 3, 2023
概括
初级保健中的连续性是有价值的,但复杂的. 新的数字工具可以增强跨时间和空间的护理连续性,尽管适应它们需要努力和针对弱势患者的具体策略.
科学领域:
- 初级保健研究研究初级保健研究
- 医疗保健服务研究 医疗服务研究
- 健康和疾病的社会学
背景情况:
- 传统的一对一医生-病人连续性在初级保健中正在下降.
- 现代通用实践涉及复杂的组织,多个员工角色和多种技术.
- 不断变化的景观需要重新评估连续性的关系,组织,社会技术和专业维度.
研究的目的:
- 重新评估英国一般实践中连续性的特点.
- 了解一般实践如何在引入远程和数字服务时定义和制定连续性.
- 开发一种新的理论框架,以了解当代初级保健中不同类型的连续性.
主要方法:
- 从2021年到2023年,在11个英国普通实践中进行的战略性,沉浸式民族学.
- 数据收集包括采访和对技术的材料分析 (例如数字步行通道).
- 理论发展与数据收集和分析并行.
主要成果:
- 连续性被普遍重视,但在各个实践中定义不同,位置和努力.
- 远程和数字模式为延伸跨时空连续性和改善数字记录共享提供了机会.
- 为弱势患者提供连续性通常是劳动密集型的,需要定制的调整.
结论:
- 提出了四种重叠的连续性类型的新型本体学:治疗关系,疾病事件,分布式工作和对社区的实践承诺.
- 这一框架有助于理论化和批评在实现护理连续性的成功和失败.
- 了解这些维度对于导航现代初级保健的复杂性和优化患者护理服务至关重要.
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