背景:农村家庭医生的角色不断发展,以适应老龄化社会的全面护理需求。对于农村地区的老年人来说,康复对于确保他们能够继续进行日常生活活动至关重要。在这个人群中,住院后的顺利出院至关重要,需要对多种疾病进行管理,康复治疗师可能需要家庭医生的支持才能达到最佳效果。因此,这项研究旨在调查农村家庭医生在患者康复中角色的变化。
方法:在日本农村医院对农村家庭医生和康复治疗师进行了人种学分析。采用建构主义扎根理论方法作为定性研究方法。数据是通过实地笔记和半结构化访谈从参与者那里收集的。
结果:使用扎根的理论方法,关于在农村社区老年患者的康复中建立家庭医生和治疗师之间的有效跨专业合作,制定了以下三个主题:1)建立相互理解和心理安全感;2)改善医疗保健专业人员与患者之间的关系;3)在农村家庭医学中创造新角色以满足不断变化的需求。
结论:确保家庭医学和康复部门之间的持续对话有助于建立理解,增强知识,加强医护人员之间的相互尊重,让工作更愉快。部门之间的持续合作也改善了专业人员与患者之间的关系,在协作治疗范式中建立信任,并支持以患者为中心的家庭医学方法。在这个框架内,了解家庭医生的能力可以导致他们在农村医院中建立新的角色。家庭医学在社区医院的老年护理中起着至关重要的作用,特别是在农村初级保健机构。应在其他环境中研究家庭医学在医院中的作用,以改善老年护理并促进医疗保健专业人员之间的相互学习和改进。
BACKGROUND: The role of rural family physicians continues to evolve to accommodate the comprehensive care needs of aging societies. For older individuals in rural areas, rehabilitation is vital to ensure that they can continue to perform activities of daily living. In this population, a smooth discharge following periods of hospitalization is essential and requires management of multimorbidity, and rehabilitation therapists may require support from family physicians to achieve optimal outcomes. Therefore, this study aimed to investigate changes in the roles of rural family physicians in patient rehabilitation.
METHODS: An ethnographic analysis was conducted with rural family physicians and rehabilitation therapists at a rural Japanese hospital. A constructivist grounded theory approach was applied as a qualitative research method. Data were collected from the participants via field notes and semi-structured interviews.
RESULTS: Using a grounded theory approach, the following three themes were developed regarding the establishment of effective interprofessional collaboration between family physicians and therapists in the rehabilitation of older patients in rural communities: 1) establishment of mutual understanding and the perception of psychological safety; 2) improvement of relationships between healthcare professionals and their patients; and 3) creation of new roles in rural family medicine to meet evolving needs.
CONCLUSIONS: Ensuring continual dialogue between family medicine and rehabilitation departments helped to establish understanding, enhance knowledge, and heighten mutual respect among healthcare workers, making the work more enjoyable. Continuous collaboration between departments also improved relationships between professionals and their patients, establishing trust in collaborative treatment paradigms and supporting patient-centered approaches to family medicine. Within this framework, understanding the capabilities of family physicians can lead to the establishment of new roles for them in rural hospitals. Family medicine plays a vital role in geriatric care in community hospitals, especially in rural primary care settings. The role of family medicine in hospitals should be investigated in other settings to improve geriatric care and promote mutual learning and improvement among healthcare professionals.