PDF(Pubmed)
Abstract：
BACKGROUND: Researchers in the Netherlands proposed the Pillars for Positive Health (PPH) as a broadly encompassing health definition to support more realistic and meaningful care planning for people living with chronic disease and other life-long health conditions. The PPH was subsequently converted to the My Positive Health (MPH) spider web visualization tool. This study sought to identify opportunities for more person-centred care planning at the point of care in home care, using the MPH tool as a framework to link comprehensive assessment and dialogue-based goal-setting.
METHODS: A modified eDelphi method was used to conduct domain mapping with a purposively sampled expert panel (n = 25). The panel consisted of researchers, health care providers, older adults and caregivers. A two-stage eDelphi process was conducted, with each stage consisting of three survey rounds. In the first stage, participants were asked to map 201 elements of the interRAI Home Care (interRAI HC) comprehensive assessment tool to the six MPH domains or \"No pillar of best fit\". The second stage focused on identifying opportunities to adapt or expand comprehensive assessment as it relates to the MPH domains.
RESULTS: In Stage 1, 189 of 201 elements reached consensus in domain mapping. These included: 80 elements for Bodily Functions, 32 for Daily Functioning, 32 for Mental Wellbeing, 24 for Quality of Life, 10 for Participation, and 1 for Meaningfulness. Ten elements were identified to have no pillar of best fit. The 12 elements that did not reach consensus in Stage 1 formed the basis for Stage 2, where expert panel participants proposed four new assessment elements in Meaningfulness and Participation and 11 additional descriptors across the six MPH domains. Of these, two elements and nine of the 11 descriptors reached consensus.
CONCLUSIONS: Findings show that elements of the interRAI HC are oriented toward the physical, functional, and mental health domains. Consequently, complementary assessment elements and/or tools may be needed to support comprehensive assessment of \'Meaningfulness\' and \'Participation\' in person-centred home and community care. Additional descriptors may also be needed to aid communication regarding the understanding and application of MPH domains.
METHODS: A modified eDelphi method was used to conduct domain mapping with a purposively sampled expert panel (n = 25). The panel consisted of researchers, health care providers, older adults and caregivers. A two-stage eDelphi process was conducted, with each stage consisting of three survey rounds. In the first stage, participants were asked to map 201 elements of the interRAI Home Care (interRAI HC) comprehensive assessment tool to the six MPH domains or \"No pillar of best fit\". The second stage focused on identifying opportunities to adapt or expand comprehensive assessment as it relates to the MPH domains.
RESULTS: In Stage 1, 189 of 201 elements reached consensus in domain mapping. These included: 80 elements for Bodily Functions, 32 for Daily Functioning, 32 for Mental Wellbeing, 24 for Quality of Life, 10 for Participation, and 1 for Meaningfulness. Ten elements were identified to have no pillar of best fit. The 12 elements that did not reach consensus in Stage 1 formed the basis for Stage 2, where expert panel participants proposed four new assessment elements in Meaningfulness and Participation and 11 additional descriptors across the six MPH domains. Of these, two elements and nine of the 11 descriptors reached consensus.
CONCLUSIONS: Findings show that elements of the interRAI HC are oriented toward the physical, functional, and mental health domains. Consequently, complementary assessment elements and/or tools may be needed to support comprehensive assessment of \'Meaningfulness\' and \'Participation\' in person-centred home and community care. Additional descriptors may also be needed to aid communication regarding the understanding and application of MPH domains.
摘要：
背景：荷兰的研究人员提出了积极健康支柱（PPH）作为广泛涵盖的健康定义，以支持对患有慢性病和其他终身健康状况的人进行更现实和有意义的护理计划。PPH随后被转换为MyPositiveHealth(MPH)蜘蛛网可视化工具。这项研究旨在确定在家庭护理中更多以人为中心的护理计划的机会，使用MPH工具作为将全面评估和基于对话的目标设定联系起来的框架。
方法：使用改进的eDelphi方法与有目的地采样的专家小组（n=25）进行域映射。小组由研究人员组成，卫生保健提供者,老年人和照顾者。进行了两阶段的eDelphi过程，每个阶段由三轮调查组成。在第一阶段,参与者被要求将interRAI家庭护理(interRAIHC)综合评估工具的201个要素映射到6个MPH领域或"无最佳拟合支柱".第二阶段的重点是确定适应或扩大与MPH领域相关的综合评估的机会。
结果：在第1阶段，201个元素中的189个在域映射中达成共识。其中包括：身体功能的80个元素，32用于日常功能，32精神健康，24生活质量10参与1是有意义的。确定了十个元素没有最佳匹配的支柱。在第1阶段未达成共识的12个要素构成了第2阶段的基础，在第2阶段，专家小组的参与者提出了“意义和参与”中的4个新评估要素以及6个MPH领域的11个额外描述符。其中,11个描述符中的两个元素和9个达成共识。
结论：研究结果表明，内部RAIHC的元素朝向物理，功能，和心理健康领域。因此,可能需要补充评估元素和/或工具来支持对以人为本的家庭和社区护理中的“有意义”和“参与”的全面评估。还可能需要附加的描述符来帮助关于MPH域的理解和应用的通信。
方法：使用改进的eDelphi方法与有目的地采样的专家小组（n=25）进行域映射。小组由研究人员组成，卫生保健提供者,老年人和照顾者。进行了两阶段的eDelphi过程，每个阶段由三轮调查组成。在第一阶段,参与者被要求将interRAI家庭护理(interRAIHC)综合评估工具的201个要素映射到6个MPH领域或"无最佳拟合支柱".第二阶段的重点是确定适应或扩大与MPH领域相关的综合评估的机会。
结果：在第1阶段，201个元素中的189个在域映射中达成共识。其中包括：身体功能的80个元素，32用于日常功能，32精神健康，24生活质量10参与1是有意义的。确定了十个元素没有最佳匹配的支柱。在第1阶段未达成共识的12个要素构成了第2阶段的基础，在第2阶段，专家小组的参与者提出了“意义和参与”中的4个新评估要素以及6个MPH领域的11个额外描述符。其中,11个描述符中的两个元素和9个达成共识。
结论：研究结果表明，内部RAIHC的元素朝向物理，功能，和心理健康领域。因此,可能需要补充评估元素和/或工具来支持对以人为本的家庭和社区护理中的“有意义”和“参与”的全面评估。还可能需要附加的描述符来帮助关于MPH域的理解和应用的通信。
