Goal setting as a feature of homecare services for older people: does it make a difference?
Goal setting as a feature of homecare services for older people: does it make a difference?
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DOI：
10.1093/ageing/afr118
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发表时间：
2012-01-01
期刊：
影响因子：
6.7
通讯作者：
Connolly, Martin J.
中科院分区：
文献类型：
--
作者：
Parsons, John;Rouse, Paul;Connolly, Martin J.
简介：在老年人家中提供的医疗服务通常是在个人功能状态的关键时刻实施的。尽管家庭护理有可能改善这种情况，但它往往侧重于治疗疾病和“照顾”患者，而不是促进独立性。恢复性家庭护理的目的是改变一种理念，即从提供护理可能会产生依赖的理念转向提供最大限度地提高独立性、自尊、自我形象和生活质量的护理，并减少所需的护理。目的：评估指定目标促进工具对转介接受家庭护理的社区老年人的健康相关生活质量 (HRQoL)、社会支持和身体功能的影响。方法：总共 205 名参与者[平均年龄 79.1 岁]岁，71.3% 女性（干预组）和 76.9 岁，60.8% 女性（对照组）]被整群随机分配给干预或对照评估者。干预部分涉及参与者与评估员一起完成目标促进工具。这就确立了康复目标。对照参与者接受了标准需求评估。然后，两组的客户都被转介给家庭护理组织提供服务。结果：随着时间的推移，干预组的 HRQoL [通过简表 36 调查 (SF-36) 测量] 发生了更大的变化 (P = 0.0001)。不同家庭护理提供商提供的服务类型存在显着差异 (P < 0.001)。目标的确定并不预示家庭护理组织将完成对参与者需求的正式审查。结论：使用目标促进工具评估老年人转诊家庭护理的需求可显着改善 HRQoL。这可能是通过更高比例的个性化活动来成功确定个人目标。研究结果有助于更好地了解改善老年人家庭护理服务所需的因素。
Introduction: health services delivered in an older person's home are often implemented at a critical juncture in an individual's functional status. Although homecare has potential to improve this situation, it often focuses on treating disease and 'taking care' of the patient rather than promoting independence. The aim of restorative homecare is to change the philosophy from one where delivery of care may create dependency to provision of care which maximises independence, self-esteem, self-image and quality of life, and reduces the care required.Aims: to assess impact of a designated goal facilitation tool on health-related quality of life (HRQoL), social support and physical function among community-dwelling older people referred for homecare.Methods: a total of 205 participants [mean age 79.1 years, 71.3% female (intervention group) and 76.9 years with 60.8% female (control group)] were cluster randomised to an intervention or control assessor. The intervention arm involved participants completing a goal facilitation tool with assessors. This established rehabilitation aims. Control participants received a standard needs assessment. Clients from both groups were then referred to a homecare organisation for service delivery.Results: there was greater change over time in HRQoL [measured by Short Form 36 Survey (SF-36)] in the intervention group (P = 0.0001). There was a marked variation across homecare providers in types of services provided (P < 0.001). Identification of a goal did not predict completion of a formalised review of participants' needs by the homecare organisation.Conclusions: use of a goal facilitation tool in assessment of an older person's needs on referral for homecare leads to significant improvements in HRQoL. This may be through a higher proportion of individualised activities tailored to a successful identification of the person's goals. The findings contribute to greater understanding of factors necessary to implement improvements in homecare services for older people.