Goal-oriented care for patients with chronic conditions or multimorbidity in primary care: A scoping review and concept analysis

被引：34

作者：

Boeykens, Dagje ^{[1
,2
]}

Boeckxstaens, Pauline ^{[2
]}

De Sutter, An ^{[2
]}

Lahousse, Lies ^{[3
]}

Pype, Peter ^{[2
,4
,5
]}

De Vriendt, Patricia ^{[1
,6
,7
]}

Van de Velde, Dominique ^{[1
,6
]}

机构：

[1] Univ Ghent, Dept Rehabil Sci Occupat Therapy, Fac Med & Hlth Sci, Ghent, Belgium

[2] Univ Ghent, Dept Publ Hlth & Primary Care, Ctr Family Med, Fac Med & Hlth Sci, Ghent, Belgium

[3] Univ Ghent, Fac Pharmaceut Sci, Dept Bioanal, Ghent, Belgium

[4] Vrije Univ Brussel, End Life Care Res Grp, Fac Med & Hlth Sci, Ghent, Belgium

[5] Univ Ghent, Ghent, Belgium

[6] Artevelde Univ Appl Sci, Dept Occupat Therapy, Ghent, Belgium

[7] Vrije Univ Brussel, Fac Med & Pharm, Dept Gerontol & Mental Hlth & Wellbeing MENT Res, Frailty Ageing FRIA Res Grp, Brussels, Belgium

来源：

PLOS ONE | 2022年 / 17卷 / 02期

关键词：

MULTIPLE CHRONIC CONDITIONS; SHARED DECISION-MAKING; PERSON-CENTERED CARE; CHRONIC DISEASE; OLDER-ADULTS; HEALTH-CARE; GENERAL-PRACTICE; QUALITY; COMMUNICATION; CONSULTATIONS;

D O I：

10.1371/journal.pone.0262843

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Background The healthcare system is faced by an ageing population, increase in chronic conditions and multimorbidity. Multimorbid patients are faced with multiple parallel care processes leading to a risk of fragmented care. These problems relate to the disease-oriented paradigm. In this paradigm the treatment goals can be in contrast with what patients value. The concept of goal-oriented care is proposed as an alternative way of providing care as meeting patients' goals could have potential benefits. Though, there is a need to translate this concept into tangible knowledge so providers can better understand and use the concept in clinical practice. The aim of this study is to address this need by means of a concept analysis. Method This concept analysis using the method of Walker and Avant is based on a literature search in PubMed, Embase, Cochrane Library, PsychInfo, CINAHL, OTSeeker and Web of Science. The method provides eight iterative steps: select a concept, determine purpose, determine defining attributes, identify model case, identify additional case, identify antecedents and consequences and define empirical referents. Results The analysis of 37 articles revealed that goal-oriented care is a dynamic and iterative process of three stages: goal-elicitation, goal-setting, and goal-evaluation. The process is underpinned by the patient's context and values. Provider and patient preparedness are required to provide goal-oriented care. Goal-oriented care has the potential to improve patients' experiences and providers' well-being, to reduce costs, and improve the overall population health. The challenge is to identify empirical referents to evaluate the process of goal-oriented care. Conclusion A common understanding of goal-oriented care is presented. Further research should focus on how and what goals are set by the patient, how this knowledge could be translated into a tangible workflow and should support the development of a strategy to evaluate the goal-oriented process of care.

引用

页数：27

共 70 条

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