Barriers and enablers to primary care in Australian residential aged care homes: A scoping review.

IF 3.8
Jolyn Johal, Heather Block, Alison Dymmott, Elsa Dent, Helen Exley, Stacey George
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引用次数: 0

Abstract

Objectives: To identify barriers and enablers to primary care in Australian residential aged care homes (RACHs).

Study design: Scoping review of articles published from 2019 to June 2024 in which barriers and enablers to primary care in Australian RACHs have been quantitatively measured, qualitatively collected or reported following implementation.

Data sources: Medline, CINAHL, AgeLine, Cochrane, Scopus, JBI, and Google Scholar.

Data synthesis: Of 1705 records screened, 28 studies were included, which were predominantly qualitative or mixed methods. They included general practitioner, nurse practitioner, pharmacy, allied health, oral health and dental services. Ninety barriers and 72 enablers were identified, and inductively classified into seven categories: System Level: 1. Funding and Resources; Organisational Level: 2. Employment and Service Models, 3. Management and Culture and, 4. Collaboration, Coordination and Communication; and Individual Level: 5. Workload, Job Satisfaction and Security, 6. Attributes, Skills and Preparedness for Role and, 7. Recipient Needs, Attitudes and Preferences. Barriers and enablers related to 'Funding and Resources' and 'Employment and Service Models' appeared key, interacting with multiple categories. On-site models were reported to foster greater collaboration and care.

Conclusions: This review revealed the systems-, organisational- and individual-level factors that influence primary care in Australian RACHs. These can be considered when designing future initiatives to increase primary care access in RACHs. With the Australian Government recently introducing funding to employ on-site pharmacists, this is an opportunity for systematic evaluation of on-site models to inform future policies, which can be considered for extension to other professions.

Registration: Open Science Framework, https://osf.io/nyqrm/.

澳大利亚老年住宅初级保健的障碍和促进因素:范围审查。
目的:确定澳大利亚住宅老年护理院(RACHs)初级保健的障碍和促进因素。研究设计:对2019年至2024年6月发表的文章进行范围审查,其中对澳大利亚RACHs初级保健的障碍和促进因素进行了定量测量,定性收集或在实施后报告。数据来源:Medline, CINAHL, AgeLine, Cochrane, Scopus, JBI,谷歌Scholar。数据综合:在筛选的1705份记录中,纳入了28项研究,主要采用定性或混合方法。这些服务包括全科医生、执业护士、药房、联合保健、口腔保健和牙科服务。确定了90个障碍和72个使能因素,并归纳分为7类:资金和资源;组织级别:2。3.就业与服务模式;管理与文化;协作、协调和沟通;个人水平:5。工作满意度与工作安全感的关系;角色的属性、技能和准备;接受者的需求、态度和偏好。与“资金和资源”以及“就业和服务模式”相关的障碍和推动因素似乎是关键,与多个类别相互作用。据报道,现场模型促进了更大的协作和关怀。结论:本综述揭示了影响澳大利亚地区初级保健的系统、组织和个人层面的因素。在设计未来旨在增加地区初级保健可及性的举措时,可以考虑这些因素。澳大利亚政府最近为雇用现场药剂师提供了资金,这是对现场模式进行系统评估的机会,为未来的政策提供信息,可以考虑将其推广到其他职业。注册:Open Science Framework, https://osf.io/nyqrm/。
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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