组织背景与辅助生活中的居民疼痛之间的关联:一项重复的跨部门研究
Matthias Hoben1,2, Shovana Shrestha2, Hana Dampf2
1School of Health Policy and Management, Faculty of Health, York University, Toronto, Canada.
International journal of geriatric psychiatry
|October 30, 2024
概括
辅助生活设施 (AL) 的组织因素与COVID-19大流行期间的居民疼痛有关. 更好的准备和执业护士的可用性与较少的疼痛有关,而人员短缺和房间限制与更多的疼痛有关.
科学领域:
- 老年学是一门学科.
- 公共卫生 公共卫生
- 医疗保健管理的管理
背景情况:
- 居住性疼痛是老年人集体护理环境中的一个重大质量挑战.
- 虽然研究了养老院,但提供较少资源的辅助生活 (AL) 设施在疼痛管理方面研究不足.
- AL居民与养老院居民面临类似的疼痛风险,需要对影响疼痛的设施级因素进行调查.
研究的目的:
- 检查在COVID-19流行病的初始浪潮期间,在辅助生活设施中的组织背景和居民疼痛之间的联系.
- 确定可能导致或减轻AL居民疼痛的特定设施级因素.
主要方法:
- 采用了重复的横截面研究设计,将AL设施调查与行政居民评估仪器-家庭护理 (RAI-HC) 数据联系起来.
- 调查评估了组织因素,包括COVID-19的准备,人员 (护士执业人员的可用性,直接护理人员短缺),员工士气,疫情和居民限制.
- 使用一般估计方程来分析组织环境与居民疼痛 (每日中度或严重强度) 之间的关联,并根据居民协变量进行调整.
主要成果:
- 在AL设施中的疼痛患病率在第1波中为20.6%,在第2波中为19.1%,这是非显著的下降.
- 与居民疼痛增加相关的因素包括更好的准备 (OR=1.383) 和将居民限制在他们的房间 (OR=1.616).
- 与降低住院疼痛相关的因素包括护士执业人员的可用性 (OR=0.761) 和人员短缺的存在 (OR=0.684).
结论:
- 在辅助生活设施中的组织背景显著影响居民的疼痛水平.
- 针对准备,人员配置模式 (例如,护士执业人员的存在) 和居民管理 (例如,避免不必要的监禁) 的干预措施对于改善护理质量至关重要.
- 解决这些组织因素为政策和管理提供了减少痛苦和提高辅助生活居民福祉的机会.
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