Table 2 Qualitative interviews on integrated home care services for older people
Theme | Subtheme | Description of specific content | Mapping in ICOPE |
|---|---|---|---|
Diverse needs for elderly integrated care services | Health knowledge needs | The OP lack expertise on disease prevention, rehabilitation exercises, medication management, etc. It is desirable to have access to regular health education and guidance, especially in areas such as chronic disease management. | Multidisciplinary team collaboration; Encouraging follow-up (establishing regular contact ). |
| Â | security needs | Safety in the home environment is crucial for OP. They place a high priority on fall prevention and desire regular assessments of their home environment, along with professional recommendations for modifications. | Add home environment assessment to comprehensive assessment and home environment modification to integrated care plan. |
| Â | Continuity and long-term care needs | The OP need continuity of professional nursing support, especially during recovery from surgery or illness, and they would like to have regular at-home integrated care services, including health monitoring, rehabilitation guidance, medication management, and so on. | Follow-up (establish long-term contact). |
Outcomes of integrated care services valued | Improvement in quality of life | The OP expect integrated care services to enhance quality of life, including improvements in physical health, mental health and socialization. | Individualized integrated care plan. |
| Â | Assessment and ongoing follow-up | The OP hope to have a professional rehabilitation assessment mechanism that can promptly identify changes in their health conditions and provide referral services. | Screening and assessment training; referrals to appropriate medical facilities based on assessment results and need for resources. |
Psychological needs and emotional support | Emotional comfort and psychological counseling | The OP hope that integrated care services include psychological care and support to alleviate loneliness or low mood. Services such as psychological counselling and mutual help groups are provided. | Increased awareness and acceptance of research in primary healthcare service centers, and collaborate, using community resources (providing counselling, group activities, etc.), and social volunteers to participate together. |
| Â | Optimizing support for family caregivers | Family members lack professional caregiving skills in caring for OP and thus bear a huge psychological and caregiving burden. It would be very beneficial if integrated care services provided appropriate skills training and emotional support to family caregivers to reduce the caregiving burden on family members. | Case managers conduct home care education to enrich home care skills and knowledge. |
Enhancement of care service capacity and improvement of support network | Strengthening communication and information access | The OP feedback that due to communication barriers and insufficient timely access to information, they are unable to dynamically obtain the best integrated care plans. | Case managers enhance communication with OP and family caregivers. Acting as a bridge, case managers will link the multidisciplinary team and provide timely feedback on dynamically adjusted integrated care intervention plans. |
| Â | Enhancing the continuity and professional capacity of community care services | It is hoped that community-based health centres will strengthen the systematic training of nursing staff and become more professional. | Training of community-based health centre personnel, social volunteers. |