Function of local networks in palliative care: a Dutch view.
Function of local networks in palliative care: a Dutch view.
复制标题
本地网络在姑息治疗中的功能：荷兰的观点。
DOI：
10.1089/jpm.2005.8.808
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发表时间：
2005
影响因子：
2.8
通讯作者：
J. Pruyn
中科院分区：
文献类型：
--
作者：
C. V. M. V. Nikbakht;C. V. D. van der Rijt;A. Visser;M. ten Voorde;J. Pruyn
背景
虽然网络的形成被认为是一种有效的方法，刺激姑息治疗的综合提供，网络形成的有用性的科学证据是稀缺的。1998年，荷兰卫生部启动了一项为期五年的姑息治疗激励方案，建立并资助了六个地区姑息治疗发展中心。这些中心是围绕关键组织，如大学医院和综合癌症中心。作为刺激方案的一部分，在每个姑息治疗发展中心引入了局部区域网络模型，以将姑息治疗服务纳入荷兰医疗保健系统。
目的
我们对荷兰西南部地区的网络形成进行了研究，该地区有240万居民。本研究旨在回答以下问题：（1）姑息治疗网络是如何发展的，哪些护理提供者参与其中，以及他们是如何运作的？(2)参与者认为姑息治疗网络取得了哪些成就？(3)根据参与者，哪些是姑息治疗网络的成功因素，哪些因素预测了成就？
设计
2000年9月至2004年1月，在该地区的姑息治疗发展中心，鹿特丹（荷兰西南部地区）的八个地方姑息治疗网络密切关注，以获得他们的特点和发展历程的信息。
测量
在研究开始时，与八个网络的协调员进行了半结构化访谈。从这些访谈和网络文件中获得的信息被用来编制一份调查问卷，以评估网络参与者的意见和经验。
结果
据绝大多数响应者说，安装网络的最重要原因是现有的地方卫生保健服务之间缺乏整合。建立这些网络是为了促进相互合作，改善获得保健服务的机会，并提高这些服务的质量。姑息治疗网络取得的最重要的成就是：增加了一个地区的同事之间的个人接触，改善了参与组织之间的参与和合作，提高了对医疗保健规定的洞察力，加入了开发新护理产品的倡议，并组织了针对患者的护理。这些网络的重要成功因素被认为是：富有成效的相互联系、定期供资和集体开发护理产品。通过逻辑回归分析，新的护理产品的集体发展和组织的情况下，讨论照顾者从不同的医疗保健服务原来是最重要的预测成功的姑息治疗网络。
结论
项目，刺激专业人员之间的沟通，似乎改善个人参与者之间的相互协作和参与组织之间，从而提高姑息治疗的质量。
BACKGROUND
Although network formation is considered an effective method of stimulating the integrated delivery of palliative care, scientific evidence on the usefulness of network formation is scarce. In 1998 the Ministry of Health of The Netherlands started a 5-year stimulation program on palliative care by founding and funding six regional Centres for the Development of Palliative Care. These centers were structured around pivotal organizations such as university hospitals and comprehensive cancer centers. As part of the stimulation program a locoregional network model was introduced within each center for the Development of Palliative Care to integrate palliative care services in the Dutch health care system.
OBJECTIVE
We performed a study on network formation in the southwestern area of The Netherlands with 2.4 million inhabitants. The study aimed to answer the following questions: (1) how do networks in palliative care develop, which care providers participate and how do they function? (2) which are the achievements of the palliative care networks as perceived by their participants? (3) which are the success factors of the palliative care networks according to their participants and which factors predict the achievements?
DESIGN
Between September 2000 and January 2004 eight local palliative care networks in the region of the Center for Development of Palliative Care-Rotterdam (southwestern area of The Netherlands) were closely followed to gain information on their characteristics and developmental course.
MEASUREMENTS
At the start of the study semistructured interviews were held with the coordinators of the eight networks. The information from these interviews and from the network documents were used to constitute a questionnaire to assess the opinions and experiences of the network participants.
RESULTS
According to the vast majority of responders, the most important reason to install the networks was the lack of integration between the existing local health care services. The networks were initiated to stimulate mutual collaboration, improve accessibility to health care services and increase the quality of these services. The most important achievements obtained by the palliative care networks were: increase in personal contacts between colleagues in a region, improved engagement and collaboration between participating organizations, enhanced insight in the health care provisions, joined initiatives for the development of new care products, and organization of patient-tailored care. Important success factors for the networks were deemed: fruitful mutual contacts, regular funding and the collective development of care products. By logistic regression analyses, the collective development of new care products and the organization of case discussions between caregivers from different health care services turned out to be the most important predictors for success of the palliative care networks.
CONCLUSIONS
Projects that stimulate the communication between professionals appear to improve the mutual collaboration between individual participants and between the participating organizations, which consequently enhances the quality of palliative care.