Implementation of eHealth to Support Assessment and Decision-making for Residents With Dementia in Long-term Care: Systematic Review.
Implementation of eHealth to Support Assessment and Decision-making for Residents With Dementia in Long-term Care: Systematic Review.
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DOI：
10.2196/29837
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发表时间：
2022-02-03
影响因子：
7.4
通讯作者：
Evans C
中科院分区：
文献类型：
--
作者：
Gillam J;Davies N;Aworinde J;Yorganci E;Anderson JE;Evans C
随着痴呆症的进展，症状和担忧会增加，给患者及其照顾者带来相当大的痛苦。在护理院和保健服务之间整合护理对于满足日益增长的护理需求和保持生活质量至关重要。然而，养老院获得高质量医疗保健的机会是不公平的。电子健康可以通过支持远程专家对护理过程（如临床评估和决策）的输入以及简化现场护理来促进这一点。如何在养老院环境中最好地实施电子健康还不清楚。本综述的目的是确定影响长期护理中的痴呆症患者实施电子健康的关键因素。对Embase、PsycINFO、MEDLINE和CINAHL进行了系统搜索，以确定2000年至2020年间发表的研究。如果研究的重点是电子健康干预措施，以改善养老院痴呆症患者的治疗和护理评估或决策，那么这些研究是合格的。对数据进行主题分析，并演绎映射到改编后的实施研究综合框架（CFIR）的6个结构。结果以叙事综合的形式呈现。总共纳入了29项研究，重点是各种电子卫生干预措施，包括远程视频咨询和临床决策支持工具。影响电子健康实施的关键因素在CFIR的所有6个构建中被确定。最受关注的内部环境是建立在养老院实施的需求上，例如提供一个有利的学习氛围，参与的领导，以及足够的培训和资源。总共确定了4个新的子结构，以通知实施要求，以满足居民需求并吸引最终用户。在养老院为痴呆症患者实施电子卫生保健是多因素和复杂的，涉及居民、工作人员和组织之间的互动。它要求强调居民的需要和最终用户参与实施过程。开发了一个关键因素的新概念模型，并将其转化为关于在长期护理中实施电子保健的18项实用建议，以指导护理院的实施者或创新者。必须成功实施电子保健，才能最大限度地吸收和推动综合保健和社会保健的改进。
As dementia progresses, symptoms and concerns increase, causing considerable distress for the person and their caregiver. The integration of care between care homes and health care services is vital to meet increasing care needs and maintain quality of life. However, care home access to high-quality health care is inequitable. eHealth can facilitate this by supporting remote specialist input on care processes, such as clinical assessment and decision-making, and streamlining care on site. How to best implement eHealth in the care home setting is unclear. The aim of this review was to identify the key factors that influence the implementation of eHealth for people living with dementia in long-term care. A systematic search of Embase, PsycINFO, MEDLINE, and CINAHL was conducted to identify studies published between 2000 and 2020. Studies were eligible if they focused on eHealth interventions to improve treatment and care assessment or decision-making for residents with dementia in care homes. Data were thematically analyzed and deductively mapped onto the 6 constructs of the adapted Consolidated Framework for Implementation Research (CFIR). The results are presented as a narrative synthesis. A total of 29 studies were included, focusing on a variety of eHealth interventions, including remote video consultations and clinical decision support tools. Key factors that influenced eHealth implementation were identified across all 6 constructs of the CFIR. Most concerned the inner setting construct on requirements for implementation in the care home, such as providing a conducive learning climate, engaged leadership, and sufficient training and resources. A total of 4 novel subconstructs were identified to inform the implementation requirements to meet resident needs and engage end users. Implementing eHealth in care homes for people with dementia is multifactorial and complex, involving interaction between residents, staff, and organizations. It requires an emphasis on the needs of residents and the engagement of end users in the implementation process. A novel conceptual model of the key factors was developed and translated into 18 practical recommendations on the implementation of eHealth in long-term care to guide implementers or innovators in care homes. Successful implementation of eHealth is required to maximize uptake and drive improvements in integrated health and social care.
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DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
影响因子：
4
作者：
De Luca, Rosaria;Bramanti, Alessia;Calabro, Rocco Salvatore
通讯作者：
Calabro, Rocco Salvatore
影响因子：
1.3
作者：
Alexander, Gregory L.;Rantz, Marilyn;Siem, Carol
通讯作者：
Siem, Carol
影响因子：
0.9
作者：
Hong, Quan Nha;Fabregues, Sergi;Pluye, Pierre
通讯作者：
Pluye, Pierre
影响因子：
2.9
作者：
Briggs AM;Valentijn PP;Thiyagarajan JA;Araujo de Carvalho I
通讯作者：
Araujo de Carvalho I