Whole systems care for post-stroke management in older adults: exploring the options for integration of health and social care systems in China

老年人中风后管理的全系统护理：探索中国卫生和社会护理系统整合的选择

• 批准号: MR/P005195/1
• 负责人: Karina Kielmann
• 金额: $ 12.92万
• 依托单位: Queen Margaret University
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2016
• 资助国家: 英国
• 起止时间: 2016 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FP005195%2F1
• 关键词: Whole; systems; care; post; stroke

As a result of social and economic change over the past few decades, a number of low- and middle-income countries have rapidly ageing populations who are more vulnerable to long-term health conditions. To date, there has been little exploration of how the experiences of high-income countries that have developed models of integrated health and social care might inform strategies in low- and middle-income countries with growing numbers of older adults. This development grant seeks to build evidence towards development of a stroke care system for older adults in Guangdong Province, China. China's population is rapidly ageing, and approximately half of adults over 60 are living with chronic diseases. High blood pressure is the main risk factor for stroke which is leading cause of death and disability in the country. Family structures, levels of social support, and access to health insurance for older adults have changed due to the 'one-child policy', internal migration, and health reforms since the late 90's. Older adults in rural and urban settings have different levels of health awareness and support and seek health care differently, but overall, the care they receive is inconsistent and patchy. This project focuses on stroke care to explore how health and social systems are working to enable or hinder continuity of care for older adults with chronic disease conditions. First, we aim to distil the lessons learned from the international literature on stroke systems of care for older adults and examine their applicability in the Chinese health systems context. Second, we will conduct field research involving data collection with older adults, lay caregivers, and professional health and social care providers in an urban and a rural prefecture of Guangdong Province (Guangzhou and Meizhou respectively) to document experiences, patterns of care-seeking, and perceived needs for chronic disease management. A specific focus on stroke patients' journeys through recovery and rehabilitation will allow us to identify how the systems currently work, and to what extent they hinder or facilitate integrated care. Third, we will examine and summarise the data collected in the form of a model that illustrates how health and social care systems currently respond and interact to meet the needs of older patients who are recovering from a stroke. Finally, we will disseminate results through a participatory workshop that includes key individuals from health and social care institutions in order to discuss and make recommendations regarding the potential strategies that can integrate elements of current health and social care systems to improve the care of older stroke patients. This work will inform the development of a larger proposal that can implement and evaluate one or more of the strategies identified to support development of a stroke care system in China.

由于过去几十年的社会和经济变化，一些中低收入国家的人口迅速老龄化，更容易受到长期健康状况的影响。迄今为止，很少有人探讨已发展综合保健和社会护理模式的高收入国家的经验如何为老年人人数不断增加的低收入和中等收入国家的战略提供信息。该发展基金旨在为中国广东省老年人中风护理系统的发展提供证据。中国人口正在迅速老龄化，60岁以上的成年人中约有一半患有慢性病。高血压是中风的主要危险因素，中风是该国死亡和残疾的主要原因。家庭结构、社会支持水平和老年人获得医疗保险的机会都因“独生子女政策”、国内移民和90年代末以来的医疗改革而发生了变化。农村和城市环境中的老年人的健康意识和支持水平不同，寻求保健的方式也不同，但总的来说，他们得到的保健不一致，而且参差不齐。该项目的重点是中风护理，以探索卫生和社会系统如何工作，以实现或阻碍慢性疾病条件下的老年人护理的连续性。首先，我们的目标是总结国际文献中关于老年人中风护理系统的经验教训，并研究其在中国卫生系统背景下的适用性。其次，我们将进行实地研究，包括收集数据，与老年人，外行照顾者，专业的健康和社会护理提供者在城市和农村地区的广东省（广州和梅州分别），以记录经验，模式的护理寻求，和感知的慢性病管理的需求。特别关注中风患者的恢复和康复之旅将使我们能够确定系统目前是如何工作的，以及它们在多大程度上阻碍或促进综合护理。第三，我们将检查和总结以模型形式收集的数据，该模型说明卫生和社会保健系统目前如何应对和相互作用，以满足正在从中风中恢复的老年患者的需求。最后，我们将通过一个参与式研讨会，包括来自卫生和社会保健机构的关键个人，以讨论和建议的潜在战略，可以整合当前的卫生和社会保健系统的元素，以改善老年中风患者的护理传播结果。这项工作将为制定一个更大的提案提供信息，该提案可以实施和评估一个或多个已确定的支持中国卒中护理系统发展的策略。

项目成果

Perceived challenges in delivering comprehensive care for patients following stroke: a qualitative study of stroke care providers in Guangdong Province, China.

为中风患者提供全面护理所面临的挑战：对中国广东省中风护理人员的定性研究。

• DOI: 10.1080/09638288.2020.1755896
• 发表时间: 2022
• 期刊: Disability and rehabilitation
• 影响因子: 2.2
• 作者: Wu C