家庭护理环境中的跨专业合作:接受家庭护理者、亲属、护士、全科医生和治疗师的观点--定性分析的结果

IF 3.2 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL BMC Family Practice Pub Date : 2024-03-04 DOI:10.1186/s12875-024-02313-8
Uta Sekanina, Britta Tetzlaff, Ana Mazur, Tilman Huckle, Anja Kühn, Richard Dano, Carolin Höckelmann, Martin Scherer, Katrin Balzer, Sascha Köpke, Eva Hummers, Christiane Müller
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Semi-structured interviews were conducted with 20 people receiving home care and with 21 relatives. Additionally, we worked with nine monoprofessional focus groups involving nurses of home care services (n = 17), general practitioners (n = 14), and therapists (n = 21). The data were analysed by content analysis. Three main categories evolved: “perception of interprofessional collaboration”, “means of communication”, and “barriers and facilitators”. People receiving home care and relatives often perceive little to no interprofessional collaboration and take over a significant part of the organisational coordination and information exchange. Interprofessional collaboration in steady care situations does exist at times and mostly occurs in coordination tasks. Contact and information exchange are rare, however, interprofessional personal encounters are sporadic, and fixed agreements and permanent contact persons are not standard. 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引用次数: 0

摘要

在德国,约有 100 万需要家庭护理的人得到了 15 400 家家庭护理服务机构的帮助。家庭护理大多是一项复杂的工作,因为跨专业合作往往具有挑战性。这可能会对患者安全造成负面影响。interprof HOME 项目旨在通过多步骤的方法,为接受居家护理的人员制定以人为本的跨专业护理理念。在其中一个工作包中,我们探讨了接受家庭护理的人员、亲属、护士、全科医生和治疗师(物理治疗师、职业治疗师和言语治疗师)如何看待在这种环境下的合作。我们对 20 名接受家庭护理的人员和 21 名亲属进行了半结构式访谈。此外,我们还与九个单专业焦点小组合作,小组成员包括家庭护理服务护士(17 人)、全科医生(14 人)和治疗师(21 人)。我们对数据进行了内容分析。主要分为三类"对专业间合作的看法"、"沟通方式 "以及 "障碍和促进因素"。接受家庭护理的人和亲属通常认为几乎没有专业间协作,并承担了组织协调和信息交流的大部分工作。在稳定的护理情况下,有时确实存在专业间合作,但大多发生在协调任务中。然而,联系和信息交流很少,专业间的个人接触也很零散,固定协议和永久联系人也不是标准配置。这些趋势随着医疗状况的复杂性而加剧。联合协作通常被认为是非常有益的。电话、传真或电子邮件等通信手段的使用方式各不相同,通常被认为是繁琐耗时的。没有跨专业的正式书面或电子文档系统。人们认为人际交往和相互信任是有益的,而缺乏相互可用性、时间有限和报酬不足则阻碍了跨专业合作。居家护理中的跨专业合作不定期进行,协调工作通常由接受居家护理的人员或亲属负责。虽然在护理工作复杂程度较低的情况下,这种个人护理模式可能足够有效,但随着护理工作复杂程度的增加,这种模式很容易受到干扰。密切互动、共同协作和固定的沟通方式可能会改善居家医疗服务。研究结果已被纳入以人为本的跨专业护理概念 interprof HOME 的开发过程中。本研究于 2021 年 11 月 3 日在国际临床试验注册平台 ClinicalTrials.gov 上注册为 NCT05149937。
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Interprofessional collaboration in the home care setting: perspectives of people receiving home care, relatives, nurses, general practitioners, and therapists—results of a qualitative analysis
About one million people in need of home care in Germany are assisted by 15,400 home care services. Home healthcare is mostly a complex endeavour because interprofessional collaboration is often challenging. This might negatively impact patient safety. The project interprof HOME aims to develop an interprofessional person-centred care concept for people receiving home care in a multistep approach. In one of the work packages we explored how people receiving home care, relatives, nurses, general practitioners, and therapists (physiotherapists, occupational therapists, and speech therapists) perceive collaboration in this setting. Semi-structured interviews were conducted with 20 people receiving home care and with 21 relatives. Additionally, we worked with nine monoprofessional focus groups involving nurses of home care services (n = 17), general practitioners (n = 14), and therapists (n = 21). The data were analysed by content analysis. Three main categories evolved: “perception of interprofessional collaboration”, “means of communication”, and “barriers and facilitators”. People receiving home care and relatives often perceive little to no interprofessional collaboration and take over a significant part of the organisational coordination and information exchange. Interprofessional collaboration in steady care situations does exist at times and mostly occurs in coordination tasks. Contact and information exchange are rare, however, interprofessional personal encounters are sporadic, and fixed agreements and permanent contact persons are not standard. These trends increase with the complexity of the healthcare situation. Joint collaborations are often perceived as highly beneficial. Means of communications such as telephone, fax, or e-mail are used differently and are often considered tedious and time-consuming. No interprofessional formal written or electronic documentation system exists. Personal acquaintance and mutual trust are perceived as being beneficial, while a lack of mutual availability, limited time, and inadequate compensation hinder interprofessional collaboration. Interprofessional collaboration in home care occurs irregularly, and coordination often remains with people receiving home care or relatives. While this individual care set-up may work sufficiently well in low complex care situations, it becomes vulnerable to disruptions with increasing complexity. Close interactions, joint collaboration, and fixed means of communication might improve healthcare at home. The findings were integrated into the development of the person-centred interprofessional care concept interprof HOME. This study is registered on the International Clinical Trails registry platform ClinicalTrials.gov as NCT05149937 on 03/11/2021.
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来源期刊
BMC Family Practice
BMC Family Practice 医学-医学:内科
CiteScore
3.20
自引率
0.00%
发文量
0
审稿时长
4-8 weeks
期刊介绍: BMC Family Practice is an open access, peer-reviewed journal that considers articles on all aspects of primary health care research. The journal has a special focus on clinical decision making and management, continuing professional education, service utilization, needs and demand, and the organization and delivery of primary care and care in the community.
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