护理一致性与养老院的护理偏好:对预先护理计划计划 (BEVOR) 影响的集群随机研究
Kornelia Götze1, Claudia Bausewein, Nadezda Chernyak
1Institute for General Practice/Family Medicine, Center for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University of Düsseldorf; Institute for General Practice/Family Medicine, Medical Faculty, University of Duisburg-Essen; Institute of Ethics, History and Theory of Medicine, LMU Munich; Department of Palliative Medicine, LMU University Hospital, Munich; Medical Faculty, Heinrich Heine University of Düsseldorf; Medical Faculty, Martin Luther University of Halle-Wittenberg, Halle (Saale); University Medical Center Göttingen; University Hospital Hamburg-Eppendorf; LMU Munich; Technical University of Applied Sciences, Rosenheim; German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN), Berlin; Faculty of Social Sciences, University of Applied Sciences Bremen; Barmer Health Insurance Fund, Wuppertal.
这项研究探讨了提前护理计划 (ACP) 是否可以改善养老院的护理一致性. 干预没有显示出显著的差异,但坚持可能会提高与偏好的护理一致性.
科学领域:
- 老年学是指老年学的学科.
- 医疗保健管理的管理
- 公共卫生 公共卫生
背景情况:
- 养老院居民的护理偏好往往没有得到满足.
- 预先护理规划 (ACP) 旨在使护理与居民的愿望保持一致.
- 一个复杂的,多层次的ACP干预措施在德国养老院中进行了测试.
研究的目的:
- 为了确定复杂的预先护理规划 (ACP) 干预措施是否能改善护理的一致性与养老院居民的偏好.
- 评估干预措施对住院率的影响,以替代护理的一致性.
- 评估二次结果,包括与护理一致性相关的过程和临床参数.
主要方法:
- 随机对照试验涉及44个德国养老院.
- 干预组接受了多级ACP计划;对照组没有接受干预.
- 使用Poisson和物流回归模型进行住院率和护理一致性的治疗意图分析.
主要成果:
- 干预组和对照组之间的住院率没有显著差异 (IRR 1.0).
- 护理与偏好的一致性在各组之间是相似的 (OR 0.9).
- 探索性分析表明,附属干预家庭的护理一致性更高 (OR 1.9);书面紧急计划显著增加.
结论:
- 由于实施不充分,ACP干预的有效性是不确定的,可能会被COVID-19大流行所加剧.
- 探索性研究结果表明,成功的机构实施与个人ACP讨论相结合,可能会改善护理的一致性.
- 需要进一步的研究来确认在最佳实施条件下干预措施的潜在好处.
相关概念视频
Documentation in Long-Term and Home Healthcare Setting
Long-Term Care Facilities
Planning Nursing Care I
Planning Nursing Care II
Standards of Care II
Nursing Implementation
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.
Restorative Care


