Delivering Person-Centered Care: Important Preferences for Recipients of Long-term Services and Supports.
Delivering Person-Centered Care: Important Preferences for Recipients of Long-term Services and Supports.
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DOI：
10.1016/j.jamda.2017.10.005
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发表时间：
2018-03
影响因子：
7.6
通讯作者：
Van Haitsma K
中科院分区：
文献类型：
--
作者：
Abbott KM;Klumpp R;Leser KA;Straker JK;Gannod GC;Van Haitsma K
虽然评估个人消费者偏好是提供以人为本的护理的重要第一步，但本研究的目的是确定对大多数接受长期服务和支持的消费者来说重要的前10个共同偏好。采用横断面调查设计。偏好评估访谈进行了255疗养院（NH）的居民和528老年人接受家庭和社区为基础的服务（HCBS）。使用日常生活偏好量表（PELI）收集消费者偏好信息。两个版本的PELI-NH的NH居民和PELI-HC的客户端接收HCBS和分析集中在41个共享项目之间的2个版本。所有受访者都独立回答了PELI问题，并对心理社会偏好项目的重要性进行了评分，从根本不重要到非常重要。10个偏好被NH居民和接受HCBS的老年人认为是重要或非常重要的。最值得注意的是，每组中超过90%的受访者将“与家人定期联系”列为重要优先事项。在这两种情况下，隐私、选择吃什么、什么时候洗澡和活动选择也是大多数人（77%-93%）的重要偏好。寻求纳入基于偏好的护理的提供者可以利用研究结果作为基础，将重要的偏好纳入整个护理环境中组织层面的护理提供过程。例如，评估所有消费者对这10个共享偏好的核心集可以帮助建立关系，过渡护理和质量改进。然而，在这项研究中，具有总体低评级重要性水平的偏好不应被怀疑或消除。重要的是，提供者要了解每个老年人的独特偏好清单，然后可以有针对性地满足偏好实现的目标。这有助于将偏好付诸实践，以提高护理质量和生活质量，最好地满足每个人的心理需求。
Although assessing individual consumer preferences are an important first step in providing person-centered care, the purpose of this study was to identify the top 10 shared preferences that are important to a majority of consumers receiving long-term services and supports. A cross-sectional survey design was used. Preference assessment interviews were conducted with 255 nursing home (NH) residents and 528 older adults receiving home and community-based services (HCBS). The Preferences for Everyday Living Inventory (PELI) was used to collect consumer preference information. Two versions of the PELI were used—the PELI-NH for NH residents and the PELI-HC for clients receiving HCBS and analysis focused on 41 shared items between the 2 versions. All respondents answered PELI questions independently and rated the importance of psychosocial preference items on a scale from not at all to a lot/very important. Ten preferences were shared as being important or very important by NH residents and older adults receiving HCBS. Most notably, more than 90% of respondents in each group rated “having regular contact with family” as an important priority. Having privacy, choices about what to eat, when to bathe, and activity options also were important preferences for a majority (77%−93%) in both settings. Providers seeking to incorporate preference-based care can utilize study results as a foundation to incorporating important preferences into the care delivery process at the organizational level across care settings. For example, assessing all consumers on this core set of 10 shared preferences can assist with relationship building, transitions in care, and quality improvement. However, preferences with aggregate low-rated levels of importance in this study should not be discredited or eliminated. It is important for providers to understand the unique preference inventory of each older adult, which can then be targeted toward meeting goals for preference fulfillment. This can aid in bringing preferences into practice to improve the quality of care and quality of life to best meet the psychosocial needs of each person.
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