背景:患有严重多发性硬化症(PwsMS)的人面临复杂的需求和日常限制,这使得获得最佳护理具有挑战性。卫生保健的实施和协调,社会服务,对于PwsMS和护理人员来说,财务方面的支持可能特别耗时和繁重。护理和病例管理(CCM)有助于确保最佳的个人护理以及更高层次的护理。当前定性研究的目标是确定PwsMS的经验,CCM的护理人员和医疗保健专家(HCS)。
方法:在当前的定性子研究中,作为更大审判的一部分,对PwsMS进行深入的半结构化访谈,在2022年2月2日至2023年1月2日期间,对与CCM有接触的护理人员和HCS进行了治疗.数据被转录,假名,测试饱和度,并根据Kuckartz使用结构化内容分析进行分析。对社会人口统计学和访谈特征进行了描述性分析。
结果:十三个PwsMS,12名护理人员和10名HCS完成了访谈。CCM函数的主要类别是演绎的:(1)看门人函数,(2)经纪人功能,(3)宣传功能,(4)对CCM标准护理的展望。然后从访谈材料中归纳地得出子类别。对852段进行了编码。与会者赞赏CCM作为一个持续和客观的联系人,信托人(92码),有能力的信息和建议来源(关于MS)(68个代码)和全面的交叉保险支持(128个代码),缓解和支持PwsMS,他们的护理人员和HCSs(67个代码)。
结论:通过跨部门持续支持与健康相关的工作,社会,财务和日常官僚事务,CCM为PwsMS提供全面和压倒一切的支持和救济,护理人员和HCS。这种干预有可能被微调并应用于类似的复杂患者组。
背景:该研究得到了科隆大学伦理委员会的批准(#20-1436),根据赫尔辛基宣言,在德国临床研究注册中心(DRKS00022771)注册。
BACKGROUND: Persons with severe Multiple Sclerosis (PwsMS) face complex needs and daily limitations that make it challenging to receive optimal care. The implementation and coordination of health care, social services, and support in financial affairs can be particularly time consuming and burdensome for both PwsMS and caregivers. Care and
case management (CCM) helps ensure optimal individual care as well as care at a higher-level. The goal of the current qualitative study was to determine the experiences of PwsMS, caregivers and health care specialists (HCSs) with the CCM.
METHODS: In the current qualitative sub study, as part of a larger trial, in-depth semi-structured interviews with PwsMS, caregivers and HCSs who had been in contact with the CCM were conducted between 02/2022 and 01/2023. Data was transcribed, pseudonymized, tested for saturation and analyzed using structuring content analysis according to Kuckartz. Sociodemographic and interview characteristics were analyzed descriptively.
RESULTS: Thirteen PwsMS, 12 caregivers and 10 HCSs completed interviews. Main categories of CCM functions were derived deductively: (1) gatekeeper function, (2) broker function, (3)
advocacy function, (4) outlook on CCM in standard care. Subcategories were then derived inductively from the interview material. 852 segments were coded. Participants appreciated the CCM as a continuous and objective contact person, a person of trust (92 codes), a competent source of information and advice (on MS) (68 codes) and comprehensive cross-insurance support (128 codes), relieving and supporting PwsMS, their caregivers and HCSs (67 codes).
CONCLUSIONS: Through the cross-sectoral continuous support in health-related, social, financial and everyday bureaucratic matters, the CCM provides comprehensive and overriding support and relief for PwsMS, caregivers and HCSs. This intervention bears the potential to be fine-tuned and applied to similar complex patient groups.
BACKGROUND: The study was approved by the Ethics Committee of the University of Cologne (#20-1436), registered at the German Register for Clinical Studies (DRKS00022771) and in accordance with the Declaration of Helsinki.