Kevin Brazil, Catherine Walshe, Julie Doherty, Andrew J E Harding, Nancy Preston, Laura Bavelaar, Nicola Cornally, Paola Di Giulio, Silvia Gonella, Irene Hartigan, Catherine Henderson, Sharon Kaasalainen, Martin Loucka, Tamara Sussman, Karolina Vlckova, Jenny T van der Steen
{"title":"在养老院实施预先护理计划干预：国际多案例研究。","authors":"Kevin Brazil, Catherine Walshe, Julie Doherty, Andrew J E Harding, Nancy Preston, Laura Bavelaar, Nicola Cornally, Paola Di Giulio, Silvia Gonella, Irene Hartigan, Catherine Henderson, Sharon Kaasalainen, Martin Loucka, Tamara Sussman, Karolina Vlckova, Jenny T van der Steen","doi":"10.1093/geront/gnae007","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objectives: </strong>The inability of individuals in the advanced stage of dementia to communicate about preferences in care at the end-of-life poses a challenge for healthcare professionals and family carers. The proven effective Family Carer Decision Support intervention has been designed to inform family carers about end-of-life care options available to a person living with advanced dementia. The objectives of the mySupport study were to adapt the application of the intervention for use in different countries, assess impact on family satisfaction and decision-making, and identify costs and supportive conditions for the implementation of the intervention.</p><p><strong>Research design and methods: </strong>A multiple-case study design was chosen where the nursing home was the case. Nursing homes were enrolled from six countries: Canada, Czech Republic, Italy, Netherlands, Republic of Ireland, and United Kingdom.</p><p><strong>Results: </strong>Seventeen cases (nursing homes) participated, with a total of 296 interviews completed including family carers, nursing home staff, and health providers. Five themes relevant to the implementation of the intervention were identified: supportive relationships; committed staff; perceived value of the intervention; the influence of external factors on the nursing home; and resource impact of delivery.</p><p><strong>Discussion and implications: </strong>There is a commonality of facilitators and barriers across countries when introducing practice innovation. A key learning point was the importance of implementation being accompanied by committed and supported nursing home leadership. The nursing home context is dynamic and multiple factors influence implementation at different points of time.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":null,"pages":null},"PeriodicalIF":4.6000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11102006/pdf/","citationCount":"0","resultStr":"{\"title\":\"Implementation of an Advance Care Planning Intervention in Nursing Homes: An International Multiple Case Study.\",\"authors\":\"Kevin Brazil, Catherine Walshe, Julie Doherty, Andrew J E Harding, Nancy Preston, Laura Bavelaar, Nicola Cornally, Paola Di Giulio, Silvia Gonella, Irene Hartigan, Catherine Henderson, Sharon Kaasalainen, Martin Loucka, Tamara Sussman, Karolina Vlckova, Jenny T van der Steen\",\"doi\":\"10.1093/geront/gnae007\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and objectives: </strong>The inability of individuals in the advanced stage of dementia to communicate about preferences in care at the end-of-life poses a challenge for healthcare professionals and family carers. 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Five themes relevant to the implementation of the intervention were identified: supportive relationships; committed staff; perceived value of the intervention; the influence of external factors on the nursing home; and resource impact of delivery.</p><p><strong>Discussion and implications: </strong>There is a commonality of facilitators and barriers across countries when introducing practice innovation. A key learning point was the importance of implementation being accompanied by committed and supported nursing home leadership. 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Implementation of an Advance Care Planning Intervention in Nursing Homes: An International Multiple Case Study.
Background and objectives: The inability of individuals in the advanced stage of dementia to communicate about preferences in care at the end-of-life poses a challenge for healthcare professionals and family carers. The proven effective Family Carer Decision Support intervention has been designed to inform family carers about end-of-life care options available to a person living with advanced dementia. The objectives of the mySupport study were to adapt the application of the intervention for use in different countries, assess impact on family satisfaction and decision-making, and identify costs and supportive conditions for the implementation of the intervention.
Research design and methods: A multiple-case study design was chosen where the nursing home was the case. Nursing homes were enrolled from six countries: Canada, Czech Republic, Italy, Netherlands, Republic of Ireland, and United Kingdom.
Results: Seventeen cases (nursing homes) participated, with a total of 296 interviews completed including family carers, nursing home staff, and health providers. Five themes relevant to the implementation of the intervention were identified: supportive relationships; committed staff; perceived value of the intervention; the influence of external factors on the nursing home; and resource impact of delivery.
Discussion and implications: There is a commonality of facilitators and barriers across countries when introducing practice innovation. A key learning point was the importance of implementation being accompanied by committed and supported nursing home leadership. The nursing home context is dynamic and multiple factors influence implementation at different points of time.
期刊介绍：
The Gerontologist, published since 1961, is a bimonthly journal of The Gerontological Society of America that provides a multidisciplinary perspective on human aging by publishing research and analysis on applied social issues. It informs the broad community of disciplines and professions involved in understanding the aging process and providing care to older people. Articles should include a conceptual framework and testable hypotheses. Implications for policy or practice should be highlighted. The Gerontologist publishes quantitative and qualitative research and encourages manuscript submissions of various types including: research articles, intervention research, review articles, measurement articles, forums, and brief reports. Book and media reviews, International Spotlights, and award-winning lectures are commissioned by the editors.
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