Eliciting and prioritising determinants of improved care in multimorbidity: A modified online Delphi study.

Journal of multimorbidity and comorbidity Pub Date : 2023-09-05 eCollection Date: 2023-01-01 DOI:10.1177/26335565231194552
Glenn Simpson, Beth Stuart, Marisza Hijryana, Ralph Kwame Akyea, Jonathan Stokes, Jon Gibson, Karen Jones, Leanne Morrison, Miriam Santer, Michael Boniface, Zlatko Zlatev, Andrew Farmer, Hajira Dambha-Miller
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Abstract

Background: Multimorbidity is a major challenge to health and social care systems around the world. There is limited research exploring the wider contextual determinants that are important to improving care for this cohort. In this study, we aimed to elicit and prioritise determinants of improved care in people with multiple conditions.

Methods: A three-round online Delphi study was conducted in England with health and social care professionals, data scientists, researchers, people living with multimorbidity and their carers.

Results: Our findings suggest a care system which is still predominantly single condition focused. 'Person-centred and holistic care' and 'coordinated and joined up care', were highly rated determinants in relation to improved care for multimorbidity. We further identified a range of non-medical determinants that are important to providing holistic care for this cohort.

Conclusions: Further progress towards a holistic and patient-centred model is needed to ensure that care more effectively addresses the complex range of medical and non-medical needs of people living with multimorbidity. This requires a move from a single condition focused biomedical model to a person-based biopsychosocial approach, which has yet to be achieved.

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在多病共存的情况下征求改善护理的决定因素并确定其优先次序:经修改的在线德尔菲研究。
背景:多病同治是全世界医疗和社会护理系统面临的一大挑战。目前,对改善这一群体护理工作的重要决定因素的研究还很有限。在这项研究中,我们旨在找出改善多重疾病患者护理的决定因素并确定其优先次序:方法:我们在英格兰与医疗和社会护理专业人士、数据科学家、研究人员、多病症患者及其护理人员开展了三轮在线德尔菲研究:结果:我们的研究结果表明,医疗保健系统仍然主要以单一病症为中心。以人为本的整体护理 "和 "协调统一的护理 "在改善多病护理的决定因素中得到了很高的评价。我们还进一步确定了一系列非医疗决定因素,这些因素对于为该群体提供整体护理非常重要:需要进一步推进以患者为中心的整体护理模式,以确保护理工作能更有效地满足多病患者复杂的医疗和非医疗需求。这就需要从以单一病症为重点的生物医学模式转变为以人为本的生物心理社会方法,而这一点尚未实现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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