在全科医院优化老年患者的个人连续性:一个集群随机分级形实用试验
Lex Groot1, Henk Schers2, J S Burgers3
1Department of General Practice, Amsterdam UMC Location VUmc, Amsterdam, Netherlands.
BMJ open
|May 21, 2024
概括
一个多组件干预,opTimise个人连续性为older (TOOL) -kit,没有改善个人连续性老年患者在一般实践中. 实施挑战和结果测量选择可能会解释观察到的效率缺乏.
科学领域:
- 初级护理研究初级护理研究
- 老年医学 老年医学
- 医疗服务研究 医疗服务研究
背景情况:
- 在一般医疗中,对老年患者来说,护理的个人连续性至关重要.
- 为了增强这种连续性,开发了一种多组件干预,即opTimise personal cContinuity for oLder (TOOL) 工具包.
- 评估TOOL-kit干预措施的有效性,可行性和可接受性至关重要.
研究的目的:
- 评估TOOL-kit干预对老年患者个人连续性的影响.
- 确定在全科医生和实践人员中干预的可行性和可接受性.
- 确定影响干预实施和有效性的因素.
主要方法:
- 一个集群随机实用试验,涉及18个月的荷兰32个一般实践机构.
- 221名医疗保健专业人员和1050名老年患者 (65岁以上) 的样本参与了调查.
- 该干预包括一个工具箱,包含34个策略. 通过尼米根连续性问卷 (NCQ) 和流程评估收集的数据.
主要成果:
- 工具包干预没有显著改善经历的个人连续性 (GP认识我,GP表现出承诺) 或团队/跨境连续性.
- 二次结果,包括工作压力和医疗保健工作人员的满意度,也保持不变.
- 过程评估表明,可接受性充足,但实施部分,受到COVID-19大流行和高工作负载的阻碍.
结论:
- 尽管TOOL-kit被认为是实用的,但它并没有增强老年患者的个人连续性.
- 不完整的实施和使用一般结果指标可能导致缺乏重大发现.
- 未来的干预应考虑更具体的结果措施和战略,以确保在实践中全面实施.
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