教育以提高初级保健中带状疹诊断的及时性:一个集群随机化研究,与嵌套定性研究的试验中的一个试验
Elizabeth Lovegrove1, Stephanie J MacNeill2, Yumeng Liu2
1Primary Care Research Centre, University of Southampton, Southampton.
概括
对非临床工作人员的教育干预并没有改善及时的带状疹评估. 对教育材料的不良参与可能解释了早期诊断和治疗启动方面的缺乏改善.
科学领域:
- 一般的做法一般的做法
- 传染病管理 传染病管理
- 医疗服务研究 医疗服务研究
背景情况:
- 疹 (shingles) 诊断通常是临床的,及时评估对于及时的抗病毒治疗至关重要.
- 早期干预可以减轻带状疹并发症,改善患者的治疗结果.
研究的目的:
- 评估针对非临床人员的实践级教育干预措施的有效性.
- 为了确定干预措施是否有助于及时评估出现带状疹症状的患者.
主要方法:
- 一个集群随机研究在一个试验 (SWAT) 涉及英格兰的一般实践.
- 干预实践获得了关于带状疹识别和管理协议的教育材料.
- 结果测量了在皮疹发作72小时和144小时内看到的患者的比例,通过线性回归分析.
主要成果:
- 教育干预并没有显著改善在皮疹发作72或144小时内评估的患者比例.
- 虽然90.9%的干预实践分发了材料,但参与度低于最佳水平.
- 定性访谈表明,海报组件是干预中最容易实施的部分.
结论:
- 测试的教育干预措施在提高带状疹患者及时评估方面无效.
- 与教育材料的不理想参与可能导致没有观察到的改善.
- 需要进一步制定战略,以提高初级保健机构的干预采用率和有效性.
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