Care challenges of home health patients living with dementia: a pathway forward with palliative care.
Care challenges of home health patients living with dementia: a pathway forward with palliative care.
复制标题
DOI：
10.1186/s12904-023-01247-9
复制
发表时间：
2023-08-29
影响因子：
3.1
通讯作者：
Jones, Christine D.
中科院分区：
文献类型：
--
作者：
Cole, Connie S.;Dafoe, Ashley;Tietbohl, Caroline K.;Jordan, Sarah R.;Huebschmann, Amy G.;Lum, Hillary D.;Jones, Christine D.
家庭医疗保健（HHC）是老年人严重疾病，特别是痴呆症（PLWD）患者的主要护理支持来源。由于人口老龄化和对非机构护理的偏好，预计对HHC的需求将继续增长。HHC机构经常面临压力，需要找到有效的方法来改善护理服务和质量。一个策略，有可能提高生活质量和患者的满意度在HHC的PLWD是姑息治疗的整合。因此，我们试图了解PLWD及其家庭护理人员的经验和需求，特别关注HHC和姑息治疗可能作为从医院到家庭的护理过渡的一部分整合的方式，以更好地支持PLWD及其家庭。我们进行了一项描述性定性研究，重点关注患者，护理人员和医疗团队成员对接受HHC的患者提供姑息治疗的观点。对访谈进行了录音和专业转录。在这个分析中，我们使用迭代的，基于团队的主题分析方法专门报告与痴呆症相关的内容。我们确定了三个主题：1）“生活在旋风中”，描述了对护理人员时间的许多竞争性要求和相关的失控感，2）“思考未来”，描述了思考日常任务之外的重要性，以开始规划未来，3）“前进的道路”，描述了将姑息治疗纳入HHC，为PLWD及其护理人员提供更好的支持。在这项定性研究中，我们的形成性工作确定了提供预期指导的重要性（例如，安全，预先护理计划）加上情感和实际护理支持（例如，寻找资源，导航保险），以维持照顾者谁是挣扎与旋风。在线版本包含补充材料，可通过10.1186/s12904-023-01247-9获得。
Home health care (HHC) is a leading source of care support for older adults with serious illness, particularly patients living with dementia (PLWD). Demand for HHC is expected to continue to grow, driven by an aging population and preference for non-institutional care. HHC agencies are frequently under pressure to find effective approaches for improving care delivery and quality. One strategy that has the potential to improve the quality of life and patient satisfaction in HHC for PLWD is the integration of palliative care. Therefore, we sought to understand the experiences and needs of PLWD and their family caregivers specifically focusing on ways that HHC and palliative care may be integrated as part of the care transition from hospital to home, to better support PLWD and their families. We conducted a descriptive qualitative study focusing on the perspectives of patients, caregivers, and healthcare team members about palliative care delivery for patients receiving HHC. Interviews were audio-recorded and professionally transcribed. In this analysis, we specifically report on dementia-related content using an iterative, team-based thematic analysis approach. We identified three themes: 1) ’Living in the Whirlwind’ which describes the many competing demands on caregivers time and the associated feeling of loss of control, 2) ’Thinking Ahead’ which describes the importance of thinking beyond the day-to-day tasks to begin planning for the future, and 3) ‘Pathways Forward’ which describes the integration of palliative care into HHC to provide enhanced support for PLWD and their caregivers. In this qualitative study, our formative work identified the importance of providing anticipatory guidance (e.g., safety, advance care planning) coupled with emotional and pragmatic care supports (e.g., finding resources, navigating insurance) to sustain caregivers who are struggling with the whirlwind. The online version contains supplementary material available at 10.1186/s12904-023-01247-9.
登录
查看更多内容
影响因子：
29
作者：
Manly, Jennifer J.;Jones, Richard N.;Weir, David
通讯作者：
Weir, David
DOI：
10.1177/10499091231155601
发表时间：
2023-02-02
影响因子：
1.9
作者：
Radcliffe, Kate G.;Halim, Madina;Harrison, Krista L.
通讯作者：
Harrison, Krista L.
影响因子：
6.3
作者：
Skains, Rachel M. M.;Zhang, Yue;Kennedy, Richard E. E.
通讯作者：
Kennedy, Richard E. E.
影响因子：
105.7
作者：
Gaertner, Jan;Siemens, Waldemar;Becker, Gerhild
通讯作者：
Becker, Gerhild
影响因子：
2.1
作者：
Brennan, Frank;Chapman, Michael;Cohen, Joshua
通讯作者：
Cohen, Joshua