通过iSupport基于Web的初级卫生保健干预支持非正式痴呆症护理人员:混合有效性-实施混合方法研究研究
Shasha Yuan1, Jingbin Zhang1, Zheng Wang1
1Institute of Medical Information/Medical Library, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Journal of medical Internet research
|September 9, 2025
概括
将iSupport计划与中国家庭医生服务相结合,改善了痴呆症护理人员的学习行为,但并没有改善主要结果. 这突显了护理人员赋权和可扩展的初级保健模式的潜力,尽管存在实施挑战.
科学领域:
- 老年学是指老年学的学科.
- 公共卫生 公共卫生
- 数字健康数字健康
背景情况:
- 痴呆症患者的非正式照顾者面临着重大未满足的需求.
- 中国由家庭医生领导的初级医疗保健系统,未充分利用其对结构化护理人员支持的潜力.
- 痴呆症护理在老年人群中提出了独特的挑战.
研究的目的:
- 评估世界卫生组织的iSupport计划与中国家庭医生合同服务对非正式痴呆症护理人员的整合.
- 通过实施研究综合框架 (CFIR) 评估实施决定因素.
- 确定对痴呆症护理人员政策一致的初级保健干预措施的有效性.
主要方法:
- 一个混合有效性实施集群随机对照试验.
- 120名非正式护理人员被招募并随机分配到干预组 (iSupport + 常规护理) 或对照组 (常规护理 + iSupport注册).
- 评估了护理人员的负担,生活质量,社会支持和学习行为,以及使用CFIR收集关于实施障碍和促进者的定性数据.
主要成果:
- 两组之间在照顾者负担,生活质量或社会支持方面没有发现显著差异.
- 干预组的学习行为显著改善 (P<.001).
- 实施障碍包括政策与财政不协调,数字化适应差距,缺乏激励,护理人员限制和内容个性化问题.
结论:
- 基于iSupport的初级医疗保健干预方案为中国的痴呆症护理人员提供了与政策一致的支持模式.
- 增强的学习行为表明了护理人员赋权的潜力,尽管核心结果没有显著改善.
- 优化数字平台,政策激励和个性化支持是成功实施初级保健机构的关键,特别是在低收入和中等收入国家.
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