在集群RCT的背景下,在比利时一般实践中实施预先护理规划 (ACP-GP) 的经验:使用RE-AIM框架进行流程评估
Julie Stevens1,2,3, Anne-Lore Scherrens4,5,6, Peter Pype6
1End-of-Life Care Research Group, Vrije Universiteit Brussel & Ghent University, Laarbeeklaan 103, Brussels, 1090, Belgium. julie.joseph.stevens@vub.be.
在一般实践中实施预先护理计划 (ACP) 是可行的,但具有挑战性. 虽然得到了好评,但ACP-GP干预措施的可持续性不足,需要未来的研究来实现有效的长期整合.
科学领域:
- 老年学是一门学科.
- 主要护理医学 医疗保健
- 医疗保健服务研究 医疗服务研究
背景情况:
- 建议在提前护理计划 (ACP) 启动时采用一般做法,但采用率仍然很低.
- 该ACP-GP干预旨在促进患者参与和ACP慢性疾病的GP自我有效性.
- 一个集群随机对照试验发现干预措施并不优于对照,需要进行过程评估.
研究的目的:
- 了解复杂的ACP-GP干预的实施过程.
- 确定影响ACP参与和GP自我有效性试验结果的因素.
- 为未来的战略提供信息,以促进在初级保健机构的ACP.
主要方法:
- 使用RE-AIM框架进行混合方法的过程评估.
- 通过招聘监测,问卷和与患者和全科医生的半结构面试收集的数据.
- 定量数据用描述性分析;定性数据用诱导性和演性分析.
主要成果:
- 一般医生的覆盖范围较低,但对大多数干预组件的采用程度中等至良好.
- 患者报告说,从ACP对话中获得安慰;一般医生重视积极的框架.
- 参与者对实施的满意度很高,但对未来的维护的意图中等.
- 总医生质疑可持续的方法,以整合ACP对话.
结论:
- 亚洲和太平洋的干预是可行的,并且可以在一般实践中成功实施.
- 确定了实施过程中的挑战和不理想的可持续性.
- 结果为未来的研究提供了指导和建议,以改善ACP促进和实施.
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