一个混合方法的多站点案例研究,以人为本的干预为中心,用于在医院中对患有痴呆症的人进行持续观察
Melanie Handley1, Danai Theodosopoulou2, Nicky Taylor3
1Centre for Research in Public Health and Community Care, School of Health, Medicine and Life Sciences, University of Hertfordshire, Hatfield, United Kingdom.
PloS one
|October 9, 2025
概括
在医院对痴呆症患者的持续观察改善了医务人员对护理质量的关注. 然而,整合心理社会需求和从反应性转向预防性护理需要进一步努力.
科学领域:
- 老年学是指老年学的学科.
- 医疗保健管理的管理
- 护理实践 护理实践
背景情况:
- 持续观察是住院痴呆症患者有危害风险的常见安全措施.
- 当前的做法是不一致的,受个人员工和组织因素的影响.
- 需要在持续观察下改善以人为中心的护理.
研究的目的:
- 了解共同设计的干预措施的实施,旨在在持续观察期间促进以人为中心的方法.
- 确定促进者和障碍物,将心理护理整合到持续观察实践中.
主要方法:
- 一个融合的并行混合方法,多个地点的案例研究在三个英国医院进行了12周.
- 数据收集包括员工-患者观察,员工采访和员工调查.
- 标准化过程理论指导的定性分析,以及NOrmalisation MeAsure Development (NoMAD) 调查数据被描述性地分析.
主要成果:
- 这项干预得到了很好的接待,观察到的增量变化包括非任务相关相互作用的增加.
- 工作人员努力优先考虑心理社会需求,而不是医疗管理和降低风险.
- 担心打扰家庭支持者或面临不充分照顾的指控,阻碍了信息共享.
结论:
- 干预支持工作人员专注于护理质量,这不是标准做法.
- 常规实施受到工作人员先前的痴呆症知识,干预措施与病房实践的协调以及竞争优先事项的影响.
- 从反应性转向预防性护理和加强观察实践需要额外的支持和工作.
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