在退伍军人卫生管理部门实施肺癌查计划的农村障碍和促进因素:定性研究
Jennifer A Lewis1,2,3,4,5, Kemberlee Bonnet6,7, David G Schlundt6,7
1Veterans Health Administration-Tennessee Valley Healthcare System, Geriatric Research, Education and Clinical Center (GRECC), Nashville, TN, United States.
Frontiers in health services
|September 7, 2023
概括
医疗保健专业人员确定了在农村退伍军人卫生管理局环境中影响肺癌查计划成功的机构和患者因素. 解决这些障碍可以提高对农村退伍军人的查范围和有效性.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 质量健康研究 质量健康研究
- 实施科学 实施科学
背景情况:
- 肺癌查对于早期检测至关重要,但农村实施面临着独特的挑战.
- 了解医疗保健专业人员的观点对于优化服务不足地区的查计划至关重要.
- 退伍军人卫生管理局 (VHA) 服务于大量的农村退伍军人人口,需要定制的查策略.
研究的目的:
- 探索医疗保健专业人员对农村VHA环境中肺癌查计划实施障碍和促进者的看法.
- 开发一个概念模型,说明这些农村实施因素.
- 确定可行的策略,以加强农村VHA环境中的肺癌查.
主要方法:
- 一项横截面的定性研究,涉及30个半结构化的电话采访,对10个VAMC的VHA医疗保健团队成员进行了采访.
- 采访以 RE-AIM (Reach Effectiveness Adoption Implementation Maintenance) 框架措施为指导,采访内容主要包括:
- 使用代的诱导和演方法分析了定性数据.
主要成果:
- 一个概念模型确定了主要主题,这些主题被分类为机构和患者环境.
- 机构障碍/促进因素包括系统层面的问题 (通信,资源,工作量),提供者因素 (态度,知识) 和外部影响 (网络,激励).
- 患者层面的因素 (脆弱性) 和社区的影响 (生态修饰因素) 也影响了查行为.
结论:
- 医疗保健专业人员的见解强调了农村肺癌查实施的关键障碍和促进因素.
- 解决已识别的因素可以提高农村VHA环境中查计划的覆盖范围,实施和有效性.
- 根据这些感知,需要针对性的干预措施,以优化农村退伍军人的肺癌查.
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