[理論的領域の枠組みに基づく中国における臨床実践ガイドラインの実施に影響を与える要因の質的体系的評価]
Xu-Dong Zhang1, Ju-Wen Zhang1, Fan-Ya Yu1
1Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine Beijing 100029, China.
まとめ
伝統的な中国医学 (TCM) のガイドラインを効果的に実施するには,証拠の質や訓練などの重要な要因に対処する必要があります. 医療の質と患者の安全を改善するためにTCMガイドラインの開発と実施を最適化することが重要です.
科学分野:
- 根拠に基づいた医療
- 医療の質の向上
- 中国伝統医学 (TCM)
背景:
- 臨床実務ガイドライン (CPG) は,医療の質と患者の安全性を向上させることを目的として,エビデンスベースの医療にとって不可欠です.
- 意図された結果と,中国伝統医学 (TCM) のガイドラインの実際の実施の間には大きなギャップが存在します.
- TCMのガイドラインの実施を最適化するために,影響する要因を体系的に調査する必要があります.
研究 の 目的:
- 中国におけるCPGの実施に影響を与える要因を特定する.
- 理論的領域の枠組み (TDF) を地元の文脈に適応する.
- ガイドラインの開発と実施を最適化するためにTCM特有の特徴を統合する.
主な方法:
- 2024年3月まで,複数のデータベース (CNKI,Wanfang,VIP,SinoMed,PubMed,EMbase) で体系的な文献検索を行う.
- CPGの実施要因に関する質的および混合方法の研究を含める.
- クリティカル・アセスメント・スキル・プログラム (CASP) を用いた方法論的品質評価; 枠組みとテーマ分析による統合; 専門家によるコンセンサス会議.
主要な成果:
- 2,388人の参加者を含む16の研究で,良い方法論的品質が示されています.
- TDFに基づいて14の領域で特定された43の影響要因.
- 重要な要因には,ガイドラインの証拠の質,訓練,リーダーシップのサポート,適用性,明確性,物質資源が含まれています.TCM特有の要因には,治療の利点,症候群の差別化,および治療の実現可能性が含まれています.
結論:
- TCMのガイドラインの開発には,高品質で明確で実行可能な勧告のためのユニークな影響要因を組み込む必要があります.
- 医療機関と学術機関は,出版後の訓練,普及,資源の利用を強化すべきである.
- TCMのガイドラインの実施を最適化することは,医療の質と患者の安全を改善するために不可欠です.
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