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首页> 外文期刊>Advances in Aging Research >Barriers and facilitators to an outreach rehabilitation program delivered in nursing homes after hip fracture surgical repair
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Barriers and facilitators to an outreach rehabilitation program delivered in nursing homes after hip fracture surgical repair

机译：髋部骨折手术修复后在疗养院实施的外展康复计划的障碍和促进者

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Objective: To identify and understand facilitators and barriers to implementing an Outreach rehabilitation program designed to improve post-operative recovery following hip fracture in long-term care residents. Residents of nursing home facilities are at considerable risk of hip fracture and minimal recovery following a hip fracture. Methods: Data were gathered over June-August, 2012 through semi-structured interviews or focus groups. Fifteen persons (n = 15) who were members of the Outreach rehabilitation team (n = 8) or relevant nursing home staff (n = 7) were interviewed. Data analysis was guided by principles of grounded theory method. Findings: Three major themes that contributed to or hindered the Outreach rehabilitation program emerged, namely, 1) the division, the separate operation and delivery of rehabilitation services; 2) building bridges, or negotiating ways to communicate and work together, and 3) strength in the structure, the acceptance of the program and the perceived benefits of the program. One main challenge to program implementation con- cerned coordinating additional rehabilitation with the rehabilitation provided within the nursing homes. Facility staff was largely unaware of the program and were unprepared to work with Outreach team members. As the program progressed, the facility staff and Outreach team were able to collaborate to overcome resident health issues impeding recovery such as cognitive impairment, language barriers and post-surgical pain control needs. Facilitators included the consistency of Outreach team members and accessible facility staff, which contributed to effective communication and trust between the Outreach team and facility staff. Facilitators also included support for the program by the Outreach team and facility staff, as well as the potential benefits of improved mobility and functional status among some program recipients. Conclusion: Although planning, implementation, and delivery of an Outreach rehabilitation program present some challenges, this study suggests that it is possible to deliver rehabilitation to older residents who fracture their hips in nursing homes.
机译：目的：确定并了解实施外展康复计划的促进因素和障碍，该计划旨在改善长期护理居民髋部骨折后的术后康复。疗养院设施的居民极有可能发生髋部骨折的风险，并且髋部骨折后的康复程度极低。方法：通过半结构化访谈或焦点小组收集了2012年6月至8月的数据。采访了外展康复团队（n = 8）或相关疗养院工作人员（n = 7）的15个人（n = 15）。数据分析遵循扎根理论方法的原则。调查结果：出现了三个有助于或阻碍外展康复计划的主题，即：1）划分，康复服务的独立运营和提供; 2）建立桥梁，或通过协商的方式进行沟通和合作，以及3）结构的强度，对计划的接受程度以及计划的预期收益。计划实施的一个主要挑战是如何将更多的康复与疗养院内的康复相协调。设施工作人员基本上不了解该计划，也没有做好与外展团队成员合作的准备。随着计划的进展，设施工作人员和外展团队能够合作克服阻碍康复的居民健康问题，例如认知障碍，语言障碍和术后疼痛控制需求。协调员包括外联团队成员和可访问的设施人员的一致性，这有助于外联团队与设施人员之间的有效沟通和信任。协调人还包括外联团队和设施工作人员对该计划的支持，以及某些计划接受者提高机动性和职能状况的潜在好处。结论：尽管扩展康复计划的规划，实施和交付带来了一些挑战，但这项研究表明，有可能为养老院中骨折的老年人提供康复服务。

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