Recommendations for Improving Chronic Care in Times of a Pandemic Based on Patient Experiences.

Autor:	Gruiskens JRJH; Department of Family Medicine, CAPHRI School of Public Health and Preventive Medicine, Maastricht University, Maastricht, The Netherlands. Electronic address: jeroen.gruiskens@maastrichtuniversity.nl., van Hoef LFM; Expertise Centre for Palliative Care, Maastricht University Medical Center+, Maastricht, The Netherlands., Theunissen MM; Expertise Centre for Palliative Care, Maastricht University Medical Center+, Maastricht, The Netherlands., Courtens AM; Expertise Centre for Palliative Care, Maastricht University Medical Center+, Maastricht, The Netherlands., Gidding-Slok AHM; Department of Family Medicine, CAPHRI School of Public Health and Preventive Medicine, Maastricht University, Maastricht, The Netherlands., van Schayck OCP; Department of Family Medicine, CAPHRI School of Public Health and Preventive Medicine, Maastricht University, Maastricht, The Netherlands., van den Beuken-van Everdingen MMHJ; Expertise Centre for Palliative Care, Maastricht University Medical Center+, Maastricht, The Netherlands.
Jazyk:	angličtina
Zdroj:	Journal of the American Medical Directors Association [J Am Med Dir Assoc] 2024 Apr; Vol. 25 (4), pp. 623-632.e5. Date of Electronic Publication: 2023 Nov 22.
DOI:	10.1016/j.jamda.2023.10.013
Abstrakt:	Objectives: The COVID-19 pandemic had a profound and pervasive impact on the health of chronic care patients and disrupted care systems worldwide. Our research aimed to assess the impact of the pandemic on chronic care provision and provide recommendations for improving care provision, based on patient experiences. Design: Qualitative semi-structured interviews were held among patients with chronic obstructive pulmonary disease (COPD) or heart failure. Setting and Participants: Using stratified sampling, 23 patients with COPD, heart failure, or both were recruited to participate in semi-structured interviews. In the summer of 2021, online interviews were conducted. Methods: An iterative process was adopted to analyze the data. Going back and forth through the data and our analytical structure, we first coded the data, and subsequently developed categories, themes, and aggregate dimensions. The data were synthesized in a data structure and a data table, which were analyzed using an interpretative approach. Results: We found 3 dimensions through which care might be improved: (1) proactive and adaptive health care organization and use of innovative technologies, (2) assistance in maintaining patient resilience and coping strategies, and (3) health care built on outreaching and person-centered care enabling identification of individual patient needs. Experiences of impaired accessibility to care, altered and unmet care demands and patient needs, and the negative impact of national containment strategies on patient resilience support the need for improvement in these dimensions. Conclusions and Implications: The in-depth insight gained on the impact of the pandemic on chronic care provision was used to propose recommendations for improving care, supported by not only the what and how but also the why developments require additional efforts made by policymakers and change agents, augmented by structural use and development of innovations. Health care organizations should be enabled to rapidly respond to changing internal and external environments, develop and implement innovations, and match care to patient needs. Competing Interests: Disclosure The authors declare no conflicts of interest. (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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