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首页> 外文期刊>BMC Health Services Research >Dementia and patient safety in the community: a qualitative study of family carers’ protective practices and implications for services
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Dementia and patient safety in the community: a qualitative study of family carers’ protective practices and implications for services

机译：痴呆症和患者安全在社区中：对家庭照顾者的保护实践的定性研究和服务的影响

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Dementia is a cause of disability and dependency associated with high demands for health services and expected to have a significant impact on resources. Care policies worldwide increasingly rely on family caregivers to contribute to service delivery for older people, and the general direction of health care policy internationally is to provide care in the community, meaning most people will receive services there. Patient safety in primary care is therefore important for future care, but not yet investigated sufficiently when services are carried out in patients' homes. In particular, we know little about how family carers experience patient safety of older people with dementia in the community. This was an explorative study, with qualitative in-depth interviews of 23 family carers of older people with suspected or diagnosed dementia. Family carers participated after receiving information primarily through health professionals working in dementia care. A semi-structured topic guide was used in a flexible way to capture participants' experiences. A four-step inductive analysis of the transcripts was informed by hermeneutic-phenomenological analysis. The ways our participants sought to address risk and safety issues can be understood to constitute protective practices that aimed to prevent or reduce the risk of harm and/or alleviate damage from harm that occurs. The protective practices relate to four areas: physical harm, economic harm, emotional harm, and relational harm. The protective practices are interlinked, and family carers sometimes prioritize one over another, and as they form part of family practice, they are not always visible to service providers. As a result, the practices may complicate interactions with health professionals and even inadvertently conceal symptoms or care needs. When family caregivers prevent harm and meet needs, some needs may be concealed or invisible to health professionals. To recognize all needs and provide effective, safe and person-centered care, health professionals need to recognize these preventive practices and seek to build a solid partnership with family carers.
机译：痴呆症是残疾和依赖性与对卫生服务的高要求相关的依赖性，并且预计对资源产生重大影响。全世界的护理政策越来越依赖家庭照顾者为老年人提供服务交付，以及国际医疗保健政策的一般方向是在社区中提供护理，这意味着大多数人将在那里收到服务。因此，初级保健的患者安全对于未来的护理是重要的，但在患者的家庭进行服务时尚未充分调查。特别是，我们对家庭照顾者如何在社区中患上痴呆症的老年人的患者安全。这是一项探索性研究，具有疑似或诊断痴呆症的23名老年人家庭护理人员的定性深入访谈。家庭照顾者在主要通过在痴呆症护理工作的健康专业人士收到信息后参加了参加的信息。半结构化主题指南以灵活的方式使用来捕捉参与者的经历。通过诠释性现象学分析，通知了对转录物的四步诱导分析。我们参与者寻求应对风险和安全问题的方式可以理解为构成旨在预防或降低伤害风险和/或减轻伤害发生的伤害的风险的保护实践。保护实践与四个方面有关：物理危害，经济危害，情绪危害和关系危害。保护措施是相互关联的，家庭照顾者有时会优先考虑另一个人，并且它们形成了一部分家庭实践，它们并不总是对服务提供商可见。因此，该实践可能使与卫生专业人员的互动复杂化，甚至无意中隐瞒症状或护理需求。当家庭照顾者防止伤害并满足需求时，有些需要可能隐藏或不可见对卫生专业人员。要认识到所有需求，并提供有效，安全和以人为本的护理，卫生专业人士需要认识到这些预防措施，并寻求与家庭照顾者建立一个坚实的伙伴关系。

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