在乌干达农村地区实施社区卫生工作者领导的慢性阻塞性肺病 (COPD) 查和转诊的挑战:使用实施成果框架进行定性研究
Rebecca Ingenhoff1,2, Nicole Robertson3, Richard Munana4,5
1Department of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Berlin, Germany.
International journal of chronic obstructive pulmonary disease
|December 4, 2023
概括
在乌干达农村地区实施社区卫生工作者领导的慢性阻塞性肺病 (COPD) 查计划面临的障碍包括意识低和诊断访问. 加强CHW支持和分散护理是可持续性的关键.
科学领域:
- 公共卫生 公共卫生
- 全球健康 全球健康
- 呼吸系统医学 呼吸系统医学
背景情况:
- 慢性阻塞性肺病 (COPD) 构成了全球重大健康负担,不成比例地影响低收入和中等收入国家 (LMICs).
- 在LMIC农村环境中,对查和诊断工具的有限访问需要创新的医疗保健提供模式.
- 社区卫生工作者 (CHW) 的干预对于解决这些进入障碍至关重要.
研究的目的:
- 调查在乌干达农村实施CHW领导的COPD查和转诊计划的促进者和障碍.
- 了解社区成员,CHW和医疗保健提供者对CHW提供的COPD编程的看法.
主要方法:
- 一项从2022年9月到10月在乌干达农村进行的定性研究.
- 与8名CHW和10名医疗保健提供者 (HCP) 进行了深入采访.
- 在实施成果框架的指导下,与34名社区成员进行了6次重点小组讨论.
主要成果:
- 实施的可接受性受到COPD意识低,缺乏实用性和耻辱感的限制.
- 螺旋测量采用受阻于可访问性和愿意参与推过程.
- 高患者数量和复杂的转诊流程阻碍了实施;为了可持续性,建议增加CHW支持和分散护理.
结论:
- 在资源有限的环境中,医疗保健领导的干预对于克服治疗和自我管理障碍至关重要.
- 在干预实施之前,形成性评估对于识别和减轻潜在障碍至关重要.
- 可持续的,以证据为基础的,局部化的方法与一致的资金是成功的社区健康倡议的必要条件.
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