社区居住体弱老年人综合护理的障碍和促进因素：应用实施科学框架的定性研究

IF 3.6 2区医学 Q2 GERIATRICS & GERONTOLOGY

Maturitas Pub Date : 2025-06-30 DOI:10.1016/j.maturitas.2025.108650

Jiaqi Yu , Hejing Chen , Yang Yang , Xuanzhi Liu , Zihang Tu , Yufeng Wang , Huaxin Si , Wendie Zhou , Yanyan Li , Beibei Yuan , Bei Wu , Cuili Wang

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引用次数: 0

摘要

目的探讨中国基层医疗团队对社区居住体弱老年人实施综合护理的障碍和促进因素。设计定性探索性研究，使用半结构化访谈和传统的内容分析。方法本研究于2024年1月至2025年6月进行，采用目的抽样方法，招募28名综合护理提供者和16名综合护理接受者。参与者接受了个人深度访谈。更新后的《实施研究综合框架》和《理论领域框架》被用于指导访谈、分析和报告调查结果。结果分析了影响弱者综合护理实施的56个实施因素，其中障碍因素26个，促进因素28个，混合因素2个。常见的障碍是卫生保健人力资源不足、包含多个组成部分的综合护理的复杂性、与特定疾病治疗相比，其优先级较低以及对能力的不信任感。结论综合护理的实施受到来自多个层面（组织和个人）和多个来源（实施者和接受者）的障碍和促进因素的影响。研究结果将为类似环境中的决策者和从业人员提供潜在的战略信息，以克服障碍和加强促进因素，促进综合护理的实施，改善老年人的生活质量并降低医疗保健费用。

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Barriers to and facilitators of integrated care for community-dwelling frail older adults: A qualitative study applying implementation science frameworks

Objectives

To identify the barriers to and facilitators of the implementation of integrated care for frail community-dwelling older adults by primary care teams in China.

Design

Qualitative explorative study, using semi-structured interviews and traditional content analysis.

Methods

This study was conducted from January 2024 to June 2025, recruited 28 deliverers of integrated care and 16 recipients through purposive sampling. Participants underwent individual in-depth interviews. The updated Consolidated Framework for Implementation Research and the Theoretical Domains Framework were applied to guide interviews, analysis and reporting of findings.

Results

The findings highlighted 56 implementation determinants of the implementation of integrated care for frail individuals: 26 barriers, 28 facilitators and 2 mixed factors. Common barriers were insufficient healthcare human resources, the complexity of integrated care with multiple components, its low priority compared with specific disease treatment, and poor beliefs about capabilities.

Conclusions

The implementation of integrated care is influenced by barriers and facilitators from multiple levels (organizational and individual) and multiple sources (implementers and recipients). The findings will inform policy makers and practitioners in similar settings of potential strategies to overcome barriers and enhance facilitators, promoting the implementation of integrated care and improving older adults' quality of life and reducing healthcare costs.

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来源期刊

Maturitas 医学-妇产科学

CiteScore

9.10

自引率

2.00%

发文量

142

审稿时长

40 days

期刊介绍： Maturitas is an international multidisciplinary peer reviewed scientific journal of midlife health and beyond publishing original research, reviews, consensus statements and guidelines, and mini-reviews. The journal provides a forum for all aspects of postreproductive health in both genders ranging from basic science to health and social care. Topic areas include:• Aging• Alternative and Complementary medicines• Arthritis and Bone Health• Cancer• Cardiovascular Health• Cognitive and Physical Functioning• Epidemiology, health and social care• Gynecology/ Reproductive Endocrinology• Nutrition/ Obesity Diabetes/ Metabolic Syndrome• Menopause, Ovarian Aging• Mental Health• Pharmacology• Sexuality• Quality of Life