改进计算机化决策支持系统干预:一种定性研究,将理论领域框架与 GUIDES 检查清单相结合.
Janet Yamada1, Andrew Kouri2, Sarah Nicole Simard1
1Daphne Cockwell School of Nursing, Faculty of Community Services, Toronto Metropolitan University, 350 Victoria Street, Toronto, ON, M5B 2K3, Canada.
这项研究使用了理论领域框架 (TDF) 和指导方针与决策支持 (GUIDES) 实施清单,以确定计算机化临床决策支持系统 (CDSS) 采用的障碍和推动因素. 顺序方法有助于通过将决定因素映射到可操作的策略来优化CDSS的实施.
科学领域:
- 医疗信息学 医疗信息学
- 医学中的行为科学.
- 临床决策支持 临床决策支持
背景情况:
- 计算机化临床决策支持系统 (CDSS) 通过弥合知识与实践之间的差距,显示出改善医疗保健的潜力.
- 然而,CDSS在现实世界中采用低于最佳水平,需要对实施障碍和推动因素进行研究.
- 了解这些决定因素对于提高健康信息技术的有效性至关重要.
研究的目的:
- 通过使用理论领域框架 (TDF) 确定电子喘管理系统 (eAMS) CDSS采用的决定因素 (障碍物/支持者).
- 将已识别的TDF信念陈述映射到指南实施与决策支持 (GUIDES) 清单中的元素.
- 探索TDF和GUIDES框架之间的关系,以优化CDSS的实施.
主要方法:
- 第一个阶段:与初级保健医生进行半结构面试,以了解eAMS CDSS的使用情况.
- 由TDF指导的内容分析,以确定障碍物和推动者.
- 第二阶段:将TDF信念陈述映射到GUIDES领域和因素.
主要成果:
- 采访了10名参与者,在12个TDF领域中产生了53个信念陈述 (34%的障碍,66%的支持者).
- 77.4%的TDF陈述与至少一个GUIDES因素联系在一起; GUIDES上下文域最常被链接 (35.8%).
- 所有TDF领域与至少一个GUIDES因素相关,表明理论领域和实施指南之间的相互联系.
结论:
- 该TDF提供了关于CDSS采用障碍和推动者的宝贵见解.
- 将TDF结果映射到GUIES中,有助于识别CDSS背景,内容和系统中必要的变化.
- 这种顺序的TDF-GUIDES方法是优化CDSS干预的新方法,需要进一步验证.
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