Integrated Care Model Salut+Social Assessment by Professionals, Informal Caregivers and Chronic or Social Dependent Patients: A Qualitative Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Research Design
2.2. Participants, Sampling and Recruitment
2.3. Data Collection and Analysis
3. Results
3.1. Description of Participants
3.2. Themes
3.3. Professionals’ Opinions
3.3.1. Theme 1: Contextualizing the Previous Scenario
“To know their portfolio of services and that they are also familiar with our portfolio of services, right? I also think it is very important” (general practitioner, P3).
“… when there is a problem, we act. Then they said “well, you have to act before there is a problem”, which is being proactive” (nurse, P4).
3.3.2. Theme 2: Achievements of the Program from the Professionals’ Perspective
“... apart from the application, it has also served us for this, to coordinate ourselves much better” (social worker, P9).
“…that I, for example, have met her, that I know what portfolio of services they have, also means that I am much more proactive with my service...... “come on, ask about the law of dependency”..., I know what I can offer users, I move them a little more, activate a little more... and I think they are already benefiting from this” (nurse, P2).
3.3.3. Theme 3: Facilitators of and Barriers to the Integrated Care Model
“So, yes... I think that it helped us. And to be more efficient, right? Maybe fewer visits, both for us and for you (social workers), has solved our problems” (general practitioner, P6).
“The Salut+Social program, what it has achieved is this, improving coordination, that we know each other, that we face each other, that we talk to each other, that we see each other every month or two, that we share information…” (general practitioner, P7).
”... we have met quite a few people who had everything locked up in a drawer and who had not finished processing (social procedures)” (general practitioner, P3).
“What happens is that when there is a serious emergency, which has to be dealt with quickly... Really, when you find yourself in that situation, it’s very overwhelming because there is no protocol in place, which I think is what needs to be worked on” (general practitioner, P6).
“Well, on a professional level, we all have quite a heavy workload, don’t we? You have a lot of visits... Then you think that this is extra work, don’t you? And you have to change the mentality of the person who, little by little, by using it, sees that it is not extra work, but that it is productive and that it can help them at specific moments…” (general practitioner, P3).
3.3.4. Theme 4: Proposals for Improving the Integrated Care Model
“… we must do what we’ve talked about many times, to change the way we work... go into the community more, go out more, to the homes of chronic patients and do fewer things sometimes in the consultation... they don’t contribute much to the patient…” (general practitioner, P3).
“… above all, more proactive... because if it’s a person who lives alone, who is 88 years old … You process the degree (of dependency) and you can process anything, because you already have this person identified, and then everything is easier. Because... otherwise, if you have to start from scratch…” (nurse, P5).
“...the application itself is fine... that is, it has made it easier for us to share information and it has the difficulty that, for both the social and health services, we have to enter (the information) in a different part, which is outside our work’s usual computer program. This makes it difficult, but accepting that difficulty I think it is an important improvement” (general practitioner, P3).
3.4. Users’ Opinions
3.4.1. Theme 5: Users’ Assessment of the Care Received within the Framework of the Program
“The truth is that I am very satisfied, because all the resources, she (the social worker) has been there to tell us “This is what is set out in law and you can do it, that too…” (P1).
“... it is a problem to go from here to there. I already go enough (to the PC center) for the pills...” (C4).
“… they (social workers) give you options, … they asked me… “Do you want her to go to the day center? It will be good for her, not being inside the house, locked up all the time…” (C1).
“It also gives you more security in knowing that, if you have a problem, they will solve it for you” (C1).
“This program is ideal, because you (social workers) have to manage everything for him... there are many families who do not have anyone who can handle these things for them” (C3).
3.4.2. Theme 6: Users’ Perceptions of the Impact on Health and Wellbeing
“… now I have an hour, before I had no one (nurse assistant). I used to leave her on the bed or sitting on the couch and went shopping. She was alone. Now I’m calmer about this...” (C3).
“…my mother also becomes happy, “They remember me, at least”. Older people value it... older people who are alone, that they come to see you, is a lot for them” (C1).
3.4.3. Theme 7: Users’ Demands for a Better Care
“... I don’t know if it they are thinking that they can do that “Every two months I will do a home visit” and that they value the patient, they value the caregiver, they value the environment”(C2).
“...my father is like this and I want my father to be valued more, because every day he is losing more” (C4).
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Code | Gender | Age | Profession | Years Employed |
---|---|---|---|---|
P1 | Female | 45 | Nurse | 20 |
P2 | Female | 59 | Nurse | 26 |
P3 | Female | 46 | General practitioner | 20 |
P4 | Male | 42 | Nurse | 14 |
P5 | Male | 50 | Nurse | 26 |
P6 | Female | 49 | General practitioner | 14 |
P7 | Female | 53 | General practitioner | 23 |
P8 | Female | 33 | Nurse | 10 |
P9 | Female | 50 | Social worker | 20 |
P10 | Female | 43 | Social worker | 17 |
P11 | Female | 45 | Social worker | 19 |
Code | Gender | Age | Employment | Relationship to Patient | Health Condition | Social Condition * | Home Care Program |
---|---|---|---|---|---|---|---|
Pt1 | Female | 56 | Disability pensioner | - | Physical disability due to accident | Dependence degree 2 | Yes |
C1 | Male | 61 | Disability pensioner | Son | Complex chronic patient, pluripathology | Dependence degree 2 | Yes |
C2 | Female | 56 | Unemployed | Daughter | Complex chronic patient, pluripathology | Dependence degree 3 | Yes |
C3 | Male | 72 | Retirement pensioner | Husband | Lewy body dementia | Dependence degree 3 | Yes |
C4 | Female | 54 | Unemployed | Daughter | Alzheimer’s disease | Dependence degree 3 | Yes |
C5 | Female | 70 | Retirement pensioner | Woman | Alzheimer’s disease | Dependence degree 3 | Yes |
C6 | Female | 42 | Employed | Daughter | Complex chronic patient, pluripathology | Dependence degree 3 | Yes |
C7 | Female | 54 | Unemployed | Daughter | Aneurysm, complex chronic patient | Dependence degree 2 | Yes |
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Gavaldà-Espelta, E.; Lleixà-Fortuño, M.d.M.; Aguilar Martín, C.; Pozo, M.; Ferré-Ferraté, M.; Tomàs-Navarro, B.; Curto-Romeu, C.; Lucas-Noll, J.; Baucells-Lluis, J.; Gonçalves, A.Q.; et al. Integrated Care Model Salut+Social Assessment by Professionals, Informal Caregivers and Chronic or Social Dependent Patients: A Qualitative Study. Int. J. Environ. Res. Public Health 2022, 19, 15467. https://doi.org/10.3390/ijerph192315467
Gavaldà-Espelta E, Lleixà-Fortuño MdM, Aguilar Martín C, Pozo M, Ferré-Ferraté M, Tomàs-Navarro B, Curto-Romeu C, Lucas-Noll J, Baucells-Lluis J, Gonçalves AQ, et al. Integrated Care Model Salut+Social Assessment by Professionals, Informal Caregivers and Chronic or Social Dependent Patients: A Qualitative Study. International Journal of Environmental Research and Public Health. 2022; 19(23):15467. https://doi.org/10.3390/ijerph192315467
Chicago/Turabian StyleGavaldà-Espelta, Ester, Maria del Mar Lleixà-Fortuño, Carina Aguilar Martín, Macarena Pozo, Maria Ferré-Ferraté, Begoña Tomàs-Navarro, Claudia Curto-Romeu, Jorgina Lucas-Noll, Jordi Baucells-Lluis, Alessandra Queiroga Gonçalves, and et al. 2022. "Integrated Care Model Salut+Social Assessment by Professionals, Informal Caregivers and Chronic or Social Dependent Patients: A Qualitative Study" International Journal of Environmental Research and Public Health 19, no. 23: 15467. https://doi.org/10.3390/ijerph192315467