ويژگي‌ها و مؤلفه‌هاي مراكز بهداشتي و درماني دوستدار سالمند: مطالعهٔ كيفي

Factors and Implications of Elder Friendly Medical Centers: A Qualitative Research

زمينه و هدف: ايجاد مراكز بهداشتي و درماني دوستدار سالمند در راستاي ارتقاي سلامت همه‌جانبهٔ سالمندان حائز اهميت است. پژوهش حاضر با هدف واكاوي ويژگي‌هاي مراكز درماني دوستدار سالمند از منظر سالمندان انجام شد. روش‌بررسي: اين تحقيق به‌روش كيفي صورت گرفت. داده‌ها ازطريق نمونه‌گيري هدف‌مند و با حداكثر تنوع مشاركت‌كنندگان از لحاظ جنسيت و سطوح اقتصادي و اجتماعي و نيز با مشاركت سي نفر از سالمندان بيشتر از 65 سال و مصاحبهٔ عميق اكتشافي جمع‌آوري شد. در مرحلهٔ بعد، استخراج محتواي مصاحبه‌ها به‌شيوهٔ كدگذاري و تحليل تماتيك در قالب مقولات اصلي و فرعي انجام پذيرفت. يافته‌ها: يافته‌هاي مطالعه نشان داد كه از نظر سالمندان، مراكز دوستدار سالمند دو ويژگي محيط‌ حمايت‌گر و محيط‌ مراقبت‌گر دارد. ريز مقولات‌ و مؤلفه‌هاي محيط‌ حمايت‌گر شامل حمايت اطلاعاتي، حمايت قانوني، حمايت خدماتي، حمايت عاطفي، حمايت تأميني، حمايت كالبدي و محيطي و حمايت اجتماعي مي‌شود. همچنين مقولات فرعي محيط مراقبت‌گر مشتمل بر ايمن‌سازي بهداشتي، ارتقاي سلامت، دقت درماني و پاسخ‌دهي فعال است. نتيجه‌گيري: نظام سلامت و درمان بايد نيازها و انتظارات سالمندان ناتوان و كم‌توان را به‌عنوان بخش بزرگي از جامعهٔ مصرف‌كنندهٔ خدمات درماني و بهداشتي كشور در آيندهٔ نزديك ملاحظه كند و توجه به افراد سالمند را در ارائهٔ خدمات بهداشتي و درماني اين گروه مدنظر قرار دهد.

Background & Objective: Providing elder-friendly health care centers is serious for multidimensional health promotion of the elderly. Iranian society encounter with elderly overpopulation in comparison with the whole population of society, during the coming years. The aim of the present research is to study the significant factors of such a health care centers from elders’ viewpoints besides their expectations and lived experiences from these centers. Elders’ welfare is an important affair, which should be obtained through planning for future health services. Methods: Qualitative methodology was used in this research. In order to understand participants’ lived-experience through analyzing their interviews, the “phenomenology” was applied as a proper method during the study. Collecting data is through purposeful sampling and deep semi-structured interviews with 30 elders above 65 years old. For purposeful sampling, the participants were selected with recognition to these factors: elders above 65 years old who wanted to participate the face-to-face interview with the researcher, they also have to be able to express their lived experience. Any cognitive difficulties, psychosis, and any severe or emergent disease were important filters during the process of participant selection. In fact, they have to lack all of the mentioned difficulties. Another important factor for purposeful sampling in this research was that the participants should had the experience of attendance at medical centers. Maximum variation interms of gender and social class was applied among participants. Then, thematic analysis was used to analyze data extracted from face to face interviews with participants. Results: Results showed that elder-friendly health centers had two significant indicators from elders’ viewpoints: “protective environment” and “attentive environment”. The protective environment includes “information protection”, “legal protection”, “service protection”, “emotional protection”, “security protection”, “physical protection”, “environmental protection”, and “social protection”. Interms of information protection, adults concentrate on promotion of sanitation information, education of self-caring, and updating caring staffs’ information. Elders who were interviewed during the study believed that extending the quality of medical services, protecting patients’ security and supplying rehabilitation equipment were part of their protective needs. From their point of view, emotional protection such as empathy, sympathy, stress deduction during important surgeries, and security protection especially wholly insurance, treatment expense deduction and equal welfare attainments are part of their protection needs. Besides the important factors mentioned above, participants referred to factors such as treatment environments and easy arrive to medical centers as part of their environmental protection needs. Attentive environment also contains sanitation security, health promotion, medical accuracy and active answering. Conclusion: Recognizing needs of elders and their viewpoints as patient stratum of society is an important affair for new policymaking in health system. Therefore, the health system must be attentive to elder-oriented services because of their needs and expectations. Understanding elders’ sanitation and health care needs and framing a practical plan for caring them would be helpful in the process of elders’ health treatment.