痴呆护理导航:建立一个共同的定义,关键原则和结果

Pub Date : 2023-08-01 DOI:10.1002/trc2.12408
Beth A. Kallmyer, David Bass, Matthew Baumgart, Christopher M. Callahan, Sarah Dulaney, Leslie C. Evertson, Sam Fazio, Katherine S. Judge, Quincy Samus
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引用次数: 2

摘要

随着医疗和患者护理系统的复杂性的增加,患者导航的概念在普及和应用的广度上都在增长。患者导航员是经过培训的人员,他们的作用不是提供临床护理,而是与患者合作,帮助他们确定自己的需求和目标,然后克服可修改的患者、提供者和系统层面的障碍。由于其高发病率、持续时间和医疗社会复杂性,痴呆症是以患者为中心的医疗服务模式(如护理导航)的理想候选者。方法阿尔茨海默病协会成立了一个由痴呆护理导航领域的研究人员组成的专家工作组,以确定循证指南。认识到痴呆症患者及其护理伙伴的独特和具有挑战性的需求,近年来美国开发和评估了几个痴呆症护理导航项目。总的来说,这些项目表明,痴呆症患者及其护理伙伴受益于痴呆症护理导航。改善痴呆患者护理系统的结果包括减少急诊就诊、降低再入院率、减少住院天数和缩短长期护理安排的延误。幸福感也会增加,因为抑郁、疾病、紧张、尴尬和行为症状会减少,自我报告的生活质量也会提高。对于护理伙伴来说,痴呆症导航导致抑郁、负担和未满足的需求减少。这篇文章提出痴呆护理导航的原则,以告知现有的和新兴的痴呆护理导航程序。几个美国痴呆症护理导航项目已经证明了痴呆症患者、护理伙伴和卫生系统的结果。阿尔茨海默氏症协会成立了一个由痴呆症护理导航领域的研究人员组成的专家工作组,以创建一个共享的定义,并确定基于证据的指导方针或原则。这些痴呆护理导航的概述原则可以告知现有的和新兴的痴呆护理导航程序。
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Dementia care navigation: Building toward a common definition, key principles, and outcomes

INTRODUCTION

As the complexity of medical treatments and patient care systems have increased, the concept of patient navigation is growing in both popularity and breadth of application. Patient navigators are trained personnel whose role is not to provide clinical care, but to partner with patients to help them identify their needs and goals and then overcome modifiable patient-, provider-, and systems-level barriers. Due to its high incidence, duration, and medical–social complexity, dementia is an ideal candidate for a patient-centric health care delivery model such as care navigation.

METHODS

The Alzheimer's Association formed an expert workgroup of researchers in the field of dementia care navigation to identify evidence-based guidelines.

RESULTS

Recognizing the unique and challenging needs of persons living with dementia and their care partners, several U.S. dementia care navigation programs have been developed and assessed in recent years. Collectively these programs demonstrate that persons living with dementia and their care partners benefit from dementia care navigation. Improved care system outcomes for the person living with dementia include reduced emergency department visits, lower hospital readmissions, fewer days hospitalized, and shorter delays in long-term care placement. Well-being is also increased, as there is decreased depression, illness, strain, embarrassment, and behavioral symptoms and increased self-reported quality of life. For care partners, dementia navigation resulted in decreased depression, burden, and unmet needs.

DISCUSSION

This article presents principles of dementia care navigation to inform existing and emerging dementia care navigation programs.

Highlights

  • Several U.S. dementia care navigation programs have demonstrated outcomes for persons living with dementia, care partners, and health systems.
  • The Alzheimer's Association formed an expert workgroup of researchers in the field of dementia care navigation to create a shared definition and identify evidence-based guidelines or principles.
  • These outlined principles of dementia care navigation can inform existing and emerging dementia care navigation programs.
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