A qualitative study of integrated care from the perspectives of patients with chronic obstructive pulmonary disease and their relatives
A qualitative study of integrated care from the perspectives of patients with chronic obstructive pulmonary disease and their relatives
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DOI：
10.1186/1472-6963-14-471
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发表时间：
2014-10-02
影响因子：
2.8
通讯作者：
Frolich, Anne
中科院分区：
文献类型：
--
作者：
Wodskou, Pernille Maria;Host, Dorte;Frolich, Anne
背景资料：针对慢性阻塞性肺疾病（COPD）制定了疾病管理计划，以促进整个医疗机构的护理整合。本研究的目的是探讨COPD患者和他们的亲属的经验，实施后的COPD疾病management programme.Methods：7个焦点小组和5个单独的访谈与34例严重或非常严重的COPD患者和两个焦点小组举行了8个他们的亲属的综合护理。数据进行了分析，使用归纳内容analysis.Results：四个主要类别的综合护理的经验出现：1）一个灵活的系统，提供适当的医疗保健和社会服务，并进一步病人的参与; 2）卫生专业人员的责任，采取主动和跟进; 3）沟通和提供信息，病人和亲属; 4）协调和专业合作。大多数病人对他们的护理感到满意，很少提出批评。然而，更不稳定和严重的疾病患者往往会遇到更多的problem.Conclusions：参与者的建议，优化医疗保健的整合，包括分配给患者的护理协调员，远程医疗解决方案，居家患者和更好的信息技术，以支持跨专业的合作。需要进一步的研究来探索这些和其他可能的解决方案，以解决COPD患者的综合护理问题。今后在这一领域的努力应参考对已查明问题的程度和相对重要性的详细了解。它还应旨在解决COPD和相关合并症的不同严重程度，并以适合相应医疗环境的方式提供护理。未来的研究还应考虑卫生专业人员的意见，以便根据所有参与COPD患者治疗的人员的经验制定干预措施。
Background: Disease management programmes have been developed for chronic obstructive pulmonary disease (COPD) to facilitate the integration of care across healthcare settings. The purpose of the present study was to examine the experiences of COPD patients and their relatives of integrated care after implementation of a COPD disease management programme.Methods: Seven focus groups and five individual interviews were held with 34 patients with severe or very severe COPD and two focus groups were held with eight of their relatives. Data were analysed using inductive content analysis.Results: Four main categories of experiences of integrated care emerged: 1) a flexible system that provides access to appropriate healthcare and social services and furthers patient involvement; 2) the responsibility of health professionals to both take the initiative and follow up; 3) communication and providing information to patients and relatives; 4) coordination and professional cooperation. Most patients were satisfied with their care and raised few criticisms. However, patients with more unstable and severe disease tended to experience more problems.Conclusions: Participant suggestions for optimizing the integration of healthcare included assigning patients a care coordinator, telehealth solutions for housebound patients and better information technology to support interprofessional cooperation. Further studies are needed to explore these and other possible solutions to problems with integrated care among COPD patients. A future effort in this field should be informed by detailed knowledge of the extent and relative importance of the identified problems. It should also be designed to address variable levels of severity of COPD and relevant comorbidities and to deliver care in ways appropriate to the respective healthcare setting. Future studies should also take health professionals' views into account so that interventions may be planned in the light of the experiences of all those involved in the treatment of COPD patients.