影响癌症护理共享决策常规实施的主要因素:一个阶段式形集群随机试验的定性过程评估
Pola Hahlweg1,2, Anja Lindig3,4, Wiebke Frerichs3,4
1Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany. p.hahlweg@uke.de.
BMC health services research
|August 8, 2023
概括
在瘤学中实施共享决策 (SDM) 是一个挑战. 这项研究确定了个人,组织和干预层面的关键因素,这些因素影响了SDM计划的成功,对未来的规划至关重要.
科学领域:
- 瘤科学 实施科学 实施科学
- 改善医疗保健质量 改善医疗保健质量
- 以患者为中心的护理
背景情况:
- 共享决策 (SDM) 在瘤学中至关重要,但在常规护理中面临实施障碍.
- 评估SDM实施计划的先前试验没有产生统计学上显著的患者报告结果.
- 进行了流程评估,以了解影响SDM实施的因素.
研究的目的:
- 调查影响瘤学多元组件共享决策计划实施的因素.
- 在临床实践中识别SDM采用障碍和促进者的障碍.
- 为 SDM 实施的未来战略提供信息.
主要方法:
- 一个步骤集群随机实施试验的定性过程评估.
- 分析了与护士和医生的采访,现场笔记和会议记录.
- 使用实施研究综合框架 (CFIR) 的演和归纳定性内容分析.
主要成果:
- 在所有CFIR领域的多个因素影响了SDM实施.
- 关键因素包括个人动机,领导力参与,资源可用性和干预适应性.
- 在各种影响因素之间观察到强烈的相互关系.
结论:
- 这种过程评估提供了关键的见解,补充了SDM试验的结果评估.
- 鉴定的因素为优化未来SDM实施策略提供了路线图.
- 了解这些因素对于成功将SDM整合到瘤护理中至关重要.
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