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Navigating the health care system: insights from consumers with multi- morbidity

机译:导航卫生保健系统:来自多种疾病的消费者的见解

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Aim. This study explored the perspective of people with multi-morbidity on navigating the health care system in Ontario, Canada.Background. Delivering health care to people with one or more chronic conditions presents a major challenge and opportunity for health care today. System redesign is informed by information from many sources including a vast body of knowledge about chronic illness. However, there is limited understanding of how patients with multi-morbidity experience navigating the health care system.Design and method. An interpretive descriptive design was used to explore how patients with multi-morbidity experience navigating the health care system. Data were collected through minimally-structured interviews and a demographic questionnaire with 20 adult participants with chronic kidney disease, and co-existing diagnoses of diabetes mellitus, and cardiovascular disease, review of the participants' health records, and secondary contextual data collection.Findings. Two main themes emerged through iterative, constant comparative analysis: navigating rough terrain and discovering how to manage the health care system. The findings of this study highlight the disjuncture and misalignments in the health care delivery system and the cumulative health care-related burden of multiple chronic conditions for consumers.Conclusion. The perspective of patients with multi-morbidity on navigating the health care system provides valuable insights into how the health care system may be redesigned to maintain and improve quality of care.Relevance to clinical practice. It is increasingly important for nurses to recognise and understand the impact of how health care is delivered on the access to and continuity of care for patients with chronic conditions and the work required from such patients.
机译:目标。这项研究探索了多种疾病患者在加拿大安大略省的医疗保健系统导航中的观点。为患有一种或多种慢性病的人们提供医疗保健是当今医疗保健的主要挑战和机遇。系统重新设计的信息来自许多来源,包括有关慢性病的大量知识。但是,对于患有多种疾病的患者如何体验医疗保健系统的了解有限。设计和方法。一种解释性的描述性设计被用于探索患有多种疾病的患者如何体验医疗保健系统。通过最小化结构的访谈和人口统计学调查表收集数据,该调查表对20名患有慢性肾脏病的成年参与者,糖尿病,心血管疾病并存的诊断,参与者的健康记录进行回顾以及二级背景数据收集。通过反复不断的比较分析,出现了两个主要主题:在崎terrain的地形上导航和发现如何管理医疗保健系统。这项研究的结果突显了医疗保健提供系统中的混乱和错位,以及消费者面临的多种慢性病的累积医疗保健相关负担。具有多种疾病的患者在医疗保健系统导航方面的观点为如何重新设计医疗保健系统以维持和改善护理质量提供了宝贵的见解。与临床实践有关。对于护士来说,认识和理解如何提供医疗服务对慢性病患者以及他们所需要的工作所能获得和持续的护理的影响越来越重要。

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