The Role of Care Navigators Working with People with Dementia and their Caregivers
The Role of Care Navigators Working with People with Dementia and their Caregivers
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DOI：
10.3233/jad-180957
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发表时间：
2019-01-01
影响因子：
4
通讯作者：
Possin, Katherine L.
中科院分区：
文献类型：
--
作者：
Bernstein, Alissa;Harrison, Krista L.;Possin, Katherine L.
背景：护理导航是一种个性化护理管理和护理协调的方法，可以帮助克服护理障碍。护理导航尚未在痴呆症中得到广泛研究，由于疾病患病率的增加和由此产生的医疗保健系统成本，需要医疗保健人员的创新。目的：确定痴呆症护理导航的促进因素和障碍，并评估痴呆症护理人员对护理导航的满意度。方法：方法包括定性研究（访谈，焦点小组，观察）与“护理团队导航员”（CTN）谁是痴呆症护理导航计划，护理生态系统的一部分，以及对护理人员进行定量调查，了解他们使用CTN的经验。成绩单进行了分析，以确定主题内的data.Results：CTNs确定了以下促进者照顾导航痴呆症：密切合作，照顾者;提供情感支持;量身定制的教育和资源;并与临床团队协调，从临床问题，金融和法律的决策。CTNS确定的障碍包括倦怠，疾病的渐进性;与初级保健提供者协调;以及为低收入，不会说英语或生活在农村地区的二元组确定资源。在这两个网站的照顾者高度评价CTNs，虽然满意度较高，在内布拉斯加州和爱荷华州。结论：创新的方法，以照顾痴呆症的交付是至关重要的。护理导航提供了一种可行的模式，可以培训无执照人员提供护理，为日益增长的痴呆症成年人及其护理人员提供更大规模的支持。
Background: Care navigation is an approach to personalized care management and care coordination that can help overcome barriers to care. Care navigation has not been extensively studied in dementia, where health care workforce innovations are needed as a result of increasing disease prevalence and resulting costs to the health care system.Objective: To identify facilitators and barriers to care navigation in dementia and to assess dementia caregiver satisfaction with care navigation.Methods: Methods include qualitative research (interviews, focus groups, observations) with "CareTeam Navigators" (CTNs) who were part of a dementia care navigation program, the Care Ecosystem, and a quantitative survey with caregivers about their experiences with CTNs. Transcripts were analyzed to identify themes within the data.Results: CTNs identified the following facilitators to care navigation in dementia: working closely with caregivers; providing emotional support; tailoring education and resources; and coordinating with a clinical team around issues ranging from clinical questions to financial and legal decision-making. The barriers CTNS identified included burn-out, the progressive nature of the disease; coordinating with primary care providers; and identifying resources for dyads who are low-income, do not speak English, or live in rural areas. Caregivers across both sites highly rated CTNs, though satisfaction was higher among those in Nebraska and Iowa.Conclusions: Innovative approaches to care delivery in dementia are crucial. Care navigation offers a feasible model to train unlicensed people to deliver care as a way to deliver larger-scale support for the growing population of adults living with dementia and their caregivers.