背景:慢性疾病会导致身体,认知和社会衰退;因此,增加个人对协助日常生活活动的家庭的依赖。跨专业合作实践(IPCP),涉及两名或两名以上与患者及其家人合作的卫生专业人员,是在初级保健中对慢性病患者进行高质量管理的一种护理模式。然而,在先前的研究中,家庭护理人员报告了他们与医疗保健提供者之间的脱节。本研究旨在探索家庭护理人员对慢性病患者的经验和观点,关于他们参与IPCP。
方法:使用建构主义扎根理论方法的各个方面。慢性病患者的家庭照顾者被邀请参加一对一的会议,半结构化采访,讲述他们在照顾亲人的情况下与IPCP的经历。采访记录使用Charmaz的四步迭代过程进行分析:(1)逐行编码,(2)集中编码,(3)对代码进行分类;(4)潜在主题和次主题开发,并编写备忘录以支持分析的每个阶段。研究小组合作进行了反身性练习,类别的概念化和主题的发展。
结果:对10名家庭照顾者的访谈(平均40分钟)的建构主义数据分析得出了两个主题。(1)为我所爱的人介入代表照顾者代表他们所爱的人承担外部角色的观念(子主题:与跨专业团队合作,支持独立和学习)。(2)承担照顾者的角色,代表影响主题1中描述的外部角色的内部因素(子主题:感觉有义务参与和变化的关系动态)。
结论:本研究概述了跨专业团队中家庭照顾者参与的外部行为和内部影响。照顾亲人所需的知识和支持目前是以临时方式学习的,卫生专业人员应该更好地促进护理人员的资源。此外,随着看护者更多地参与IPCP,看护者与其所爱的人之间的关系动态发生变化,并影响卫生专业人员参与家庭看护者的方式和程度。
■照顾者是这项定性研究中涉及的研究人群。有慢性病的患者倡导者,是非正式的家庭照顾者,参与了这项研究的创作和设计,包括对研究问题的回顾,参与者信息表和面试指南。
Chronic conditions can lead to physical, cognitive and social decline; thus, increasing an individual\'s dependence on family who assist with activities of daily living. Interprofessional collaborative practice (IPCP), involving two or more health professionals working with the patient and their family, is one model of care for the high-quality management of individuals with chronic conditions in primary care. Nevertheless, family carers have reported a disconnect between themselves and healthcare providers in previous research. This study aimed to explore the experiences and perspectives of family carers for individuals with chronic conditions, regarding their involvement in IPCP.
Aspects of constructivist grounded theory methodology were used. Family carers of individuals with chronic conditions were invited to participate in a one-on-one, semistructured interview about their experiences with IPCP in the care of their loved one. Interview transcripts were analysed using Charmaz\'s four-step iterative process: (1) line-by-line coding, (2) focused coding, (3) categorisation of codes and (4) potential theme and subtheme development with memo writing to support each phase of analysis. The research team collaborated on reflexivity exercises, the conceptualisation of categories and the development of themes.
Constructivist data analysis of interviews (average 40 min) with 10 family carers resulted in two themes. (1) Stepping in for my loved one represents the notion that carers take on external roles on behalf of their loved ones (subthemes: working with interprofessional teams, supporting independence and learning as I go). (2) Taking on the carer role, represents the internal factors that influence the external roles described in theme 1 (subthemes: feeling obligated to be involved and changing relationship dynamics).
This study outlines the external actions and internal influences on family carer involvement in an interprofessional team. The required knowledge and support to care for their loved ones is currently learned in an ad hoc manner, and carers\' resources should be better promoted by health professionals. Additionally, the relationship dynamics between a carer and their loved one change as the carer becomes more involved in IPCP and influences how and the extent health professionals involve family carers.
Carers were the study population involved in this qualitative study. Patient advocates who have chronic conditions, and are informal family carers, were involved in the creation and design of this study, including a review of the research question, participant information sheet and the interview guide.