评估姑息关怀的价值何在?从社区提供的姑息关怀中学习。

IF 2.7 Q2 HEALTH CARE SCIENCES & SERVICES
Palliative Care and Social Practice Pub Date : 2024-10-07 eCollection Date: 2024-01-01 DOI:10.1177/26323524241287223
Sandy Whitelaw, Devi Vijay, David Clark
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引用次数: 0

摘要

背景:世界卫生组织 2018 年《阿斯塔纳宣言》将初级医疗保健视为全民健康覆盖的关键,并进一步支持建立可持续的社区姑息关怀模式这一目标。然而,评估此类模式的益处仍面临着方法论和概念上的挑战:探讨与印度喀拉拉邦社区姑息关怀方法相关的评估问题:设计:采用快速评估方法进行启发性案例研究:方法:定性访谈、文献分析以及对家庭护理和社区组织的观察:结果:我们使用三个相关的 "画布 "对印度喀拉拉邦的一项社区姑息关怀计划进行了评估:(1) 基于社区的 "复杂 "多因素干预措施及其对评估的影响;(2) 在任何评估过程中强调价值观的 "公理 "取向;(3) 评估证据在后殖民背景下的地位。支持护理过程的三种价值观非常重要:异质性、发言权和权力下放。我们确定了与一阶、二阶和三阶结果相关的 "关注对象":(1) 个人和组织;(2) 核心领域之外的非预期目标;(3) 领域内外的间接、远期影响:我们展示了在复杂的社区环境中,如何通过关注社区关怀价值的重要性来成功完成对姑息关怀的评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Where are the values in evaluating palliative care? Learning from community-based palliative care provision.

Background: The World Health Organization Astana Declaration of 2018 sees primary healthcare as key to universal health coverage and gives further support to the goal of building sustainable models of community palliative care. Yet evaluating the benefits of such models continues to pose methodological and conceptual challenges.

Objective: To explore evaluation issues associated with a community-based palliative care approach in Kerala, India.

Design: An illuminative case study using a rapid evaluation methodology.

Methodology: Qualitative interviews, documentary analysis and observations of home care and community organising.

Results: We appraise a community palliative care programme in Kerala, India, using three linked 'canvases' of enquiry: (1) 'complex' multi-factorial community-based interventions and implications for evaluation; (2) 'axiological' orientations that foreground values in any evaluation process and (3) the status of evaluative evidence in postcolonial contexts. Three values underpinning the care process were significant: heterogeneity, voice and decentralisation. We identify 'objects of interest' related to first-, second- and third-order outcomes: (1) individuals and organisations; (2) unintended targets outside the core domain and (3) indirect, distal effects within and outside the domain.

Conclusion: We show how evaluation of palliative care in complex community circumstances can be successfully accomplished when attending to the significance of community care values.

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来源期刊
Palliative Care and Social Practice
Palliative Care and Social Practice Nursing-Advanced and Specialized Nursing
CiteScore
2.90
自引率
0.00%
发文量
37
审稿时长
9 weeks
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