背景:患有痴呆症的疗养院居民的护理复杂性不断增加,需要新的护理模式来加强专业合作。为促进新护理模式的可持续实施,重要的是要将它们与护理现实联系起来。然而,对德国疗养院的专业内和跨专业组织和提供护理知之甚少。因此,这项研究的目的是探索当前的护理状况,在照顾患有痴呆症的居民方面,有关专业内和跨专业合作的问题和优势。
方法:我们进行了全面的多案例研究。患有痴呆症的居民得到照顾的个人护理单位被定义为病例。上下文是由各自的疗养院及其与北莱茵-威斯特法伦州联邦州的地区隶属关系建立的。我们采用了定性的面对面访谈,用于数据收集的文档和背景调查表。不同的证据来源有助于捕捉互补的观点并验证调查结果。首先,使用演绎-归纳内容分析对收集的定性数据进行分析.第二,确定了案例之间的异同,以详细阐述特定案例和跨案例的模式和主题。报告遵循组织案例研究的EQUATOR报告指南。
结果:我们包括四个护理单位,包括21名专业人员(护士,医师,社会工作者,物理治疗师,药剂师)和14名患有痴呆症的居民的亲属。分析揭示了四个类别来描述所有情况下当前的专业内和跨专业合作:参与者及其角色,服务交付,协调和治理,和沟通渠道。此外,我们确定了在所有情况下与专业内和专业间合作的优势和问题相关的三个类别:角色理解,团队合作,沟通和交流。虽然我们检查了类似的护理单位,我们发现,在实现专业协作和由此产生的问题和优势,是连接到所使用的组织环境和战略的差异。
结论:尽管专业合作遵循给定的模式,但这些模式确实因上下文而异,被认为是有问题的和零碎的。因此,合作中发现的差异和问题需要在未来的研究中解决,以开发和成功实施量身定制的创新护理模式。
BACKGROUND: The increasing care complexity of nursing home residents living with dementia requires new care models that strengthen professional collaboration. To contribute to the sustainable implementation of new care models, it is important that they are linked to the care reality. However, little is known about intra- and interprofessional organization and provision of care in German nursing homes. Therefore, the aim of this
study was to explore the current care situation, problems and strengths regarding intra- and interprofessional collaboration in the care of residents living with dementia.
METHODS: We conducted a holistic multiple case
study. The individual care units in which residents living with dementia are cared for were defined as cases. The context was built by the respective nursing homes and their regional affiliation to the federal state of North Rhine-Westphalia. We used qualitative face-to-face interviews, documents and context questionnaires for data collection. The different sources of evidence served to capture complementary perspectives and to validate the findings. First, the collected qualitative data were analyzed using deductive-inductive content analysis. Second, similarities and differences between the cases were identified to elaborate case-specific and cross-case patterns and themes. The reporting followed the EQUATOR reporting guideline for organizational case studies.
RESULTS: We included four care units comprising 21 professionals (nurses, physicians, social worker, physiotherapist, pharmacist) and 14 relatives of residents living with dementia. The analysis revealed four categories to describe current intra- and interprofessional collaboration in all cases: actors and their roles, service delivery, coordination and governance, and communication channel. Moreover, we identified three categories that relate to the strengths and problems of intra- and interprofessional collaboration in all cases: role understanding, teamwork, and communication and exchange. Although we examined similar care units, we found differences in the realization of professional collaboration and resulting problems and strengths that are connected to the organizational contexts and strategies used.
CONCLUSIONS: Even though professional collaboration follows given patterns; these patterns do differ context-specifically and are perceived as problematic and fragmentary. Therefore, the identified differences and problems in collaboration need to be addressed in future research to develop and successfully implement tailored innovative care models.