Changing Focus: End-of-Life Care in a New York State Managed Long-Term Care Program
Changing Focus: End-of-Life Care in a New York State Managed Long-Term Care Program
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DOI：
10.1177/0733464817737620
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发表时间：
2019-10-01
影响因子：
3
通讯作者：
Waldrop, Deborah P.
中科院分区：
文献类型：
--
作者：
Meeker, Mary Ann;Waldrop, Deborah P.
在美国，管理长期护理计划提供了一个非机构的方法来满足越来越多的体弱老人的需求。提供支持生活质量和死亡质量的服务带来了独特的挑战。使用定性描述性设计，我们从护理提供者的角度探讨了这些挑战。使用定性内容分析技术确定的主题适用于33个半结构化访谈的成绩单。专业人员组成的跨学科护理团队和家庭健康助理直接护理提供者描述的线索，他们确定运动到生命的终结阶段，他们的理解如何护理改变，他们的关注和改进建议。当不断变化的护理需求得到满足时，“好死”随之而来，但这并不总是可能的。管理的长期护理计划被要求发展能力，将死亡阶段纳入他们所照顾的每个生命的全部故事。
In the United States, managed long-term care programs offer a noninstitutional approach to meeting the needs of increasing numbers of frail elders. Providing services that support both quality of life and quality of dying poses unique challenges. Using a qualitative descriptive design, we explored these challenges from the perspectives of care providers. Themes were identified using qualitative content analysis techniques applied to transcripts of 33 semistructured interviews. Professionals comprising an interdisciplinary care team and home health aide direct care providers described cues by which they identified movement into the end-of-life phase, their understandings of how care changed, and their concerns and recommendations for improvement. When the changing care needs could be met, a "good death" ensued, but that was not always possible. Managed long-term care programs are called upon to develop the capacity to integrate the phase of dying into the full story of each life for which they care.