预先护理规划的实施,流程和结果:在中国长期护理设施中开发的一种文化和上下文适当的程序理论
Yuxin Zhou1, Ariel Wang2, Clare Ellis-Smith1
1Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, Florence Nightingale Faculty of Nursing Midwifery & Palliative Care, King's College London, London, UK.
概括
这项研究开发了中国长期护理机构预先护理计划 (ACP) 的方案理论. 它概述了实施ACP的途径,以改善居民护理和结果,适应国际使用.
科学领域:
- 老年学是一门学科.
- 医疗保健服务研究 医疗服务研究
- 社会学 社会学 社会学
背景情况:
- 预先护理规划 (ACP) 与长期护理设施 (LTCF) 的积极结果有关,但因果途径不太了解,并且特定于环境.
- 缺乏明确性阻碍了文化适应和对非洲国家和地区干预措施的评估.
- 这项研究的重点是制定中国LTCF中ACP的方案理论,详细说明其实施,流程和结果.
研究的目的:
- 开发一个程序理论,概述预先护理规划 (ACP) 的因果关系路径.
- 了解中国长期护理机构 (LTCF) 中ACP的实施,流程和成果.
- 提供一个文化适应性框架,用于评估和实施ACP干预措施.
主要方法:
- 采用了使用变化理论 (ToC) 方法的探索性定性设计.
- 进行了两次ToC研讨会 (面对面和在线) 与37名参与者在老年护理方面有经验.
- 以现实主义的回顾和初级定性研究为基础,并进行主题分析,以开发程序理论和ToC地图.
主要成果:
- 构建了一个程序理论,详细介绍了五个ACP的先决条件领域:领导力买入,资源可用性,培训/意识,居民识别和文化敏感的沟通.
- 确定了针对先决条件的9个干预组件,包括宣传活动和员工培训.
- 突出了潜在的影响,例如培养对"良好的死亡"的积极态度和增加息护理接受度.
结论:
- 开发的中期计划理论作为一种启发式工具,可适应全球上下文特定的ACP干预措施.
- 强调家庭参与的干预组件特别适用于东亚地区,这些地区重视关系自主性和以家庭为中心的决策.
- 该计划理论为中国LTCF的可行性测试做好了准备.
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