社会处方在实践中是什么样子的? 一个定性案例研究,以实践理论为基础
Sara Calderón-Larrañaga1, Trish Greenhalgh2, Sarah Finer3
1Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK; Bromley By Bow Health Partnership, XX Place Health Centre, Mile End Hospital, Bancroft Rd, Bethnal Green, London, E1 4DG, UK.
社会处方 (SP) 将患者与社区服务联系起来. 通过谈判和重新发明,将SP实践适应患者需求是成功实施和更好的健康结果的关键.
科学领域:
- 公共卫生 公共卫生
- 卫生社会学 卫生社会学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 社会处方 (SP) 将初级保健患者与社区资源联系起来.
- 研究了SP的有效性,但复杂系统中的机制尚不清楚.
- 需要关注不同环境中的高风险2型糖尿病 (T2D) 人群.
研究的目的:
- 调查SP实践是如何为T2D高风险的个体颁布的.
- 探索实践理论对理解SP实施的影响.
- 在多民族,社会经济上贫困的初级保健环境中检查SP.
主要方法:
- 使用实践理论进行定性案例研究.
- 与临床医生,链接工作者和SP组织进行了35次半结构化访谈.
- 30小时的民族学观察和文档分析.
主要成果:
- 确定了各种各样的SP实践方法:适应性 ("我做什么需要"),受约束 ("我做我能做的") 和顺从 ("我做我被告知").
- 实践显示了紧张,适应性方法具有更大的潜力来支持高T2D风险患者.
- 成功采用SP需要资源和条件适应,谈判,和以患者为中心的重塑.
结论:
- SP的制定有所不同,影响其支持高T2D风险患者的潜力.
- 将SP适应患者需求对于成功实施至关重要.
- 个人,关系,组织和机构因素对于有效的SP至关重要.
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