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探索影响先进慢性病基于证据的方法的因素:一项涉及护士和医生的定性研究
Elena Pintado-Outumuro1,2, Victoria Morin-Fraile3,4, Betlem Salvador-González5,2
1Primary Care Center El Pla. Servei d'Atenció Primària Baix Llobregat Centre, Atenció Primària Metropolitana Sud, Institut Català de la Salut, Sant Feliu de Llobregat, Barcelona, 08980, Spain.
BMC primary care
|May 21, 2024
概括
初级保健中的障碍阻碍了基于证据的高级慢性病 (ACKD) 管理. 解决专业态度,环境因素和护理协调对于改善ACKD患者的治疗结果至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 主要护理医学 医疗保健
- 医疗保健服务研究 医疗服务研究
背景情况:
- 晚期慢性病 (ACKD) 对心血管和事件构成重大风险,影响生活质量和预期寿命.
- 目前在初级保健中ACKD管理提供了改进的机会,专业和环境因素作为关键障碍.
- 了解这些障碍对于优化患者护理途径至关重要.
研究的目的:
- 分析初级保健专业人员对基于证据的ACKD管理的态度,主观规范和感知行为控制.
- 确定影响临床实践指南和电子病记录实施的心理因素.
- 在初级保健环境中,为提高ACKD护理的策略提供信息.
主要方法:
- 使用基于计划行为理论的解释性现象学方法进行定性研究.
- 探索临床实践指南的实施和电子病记录的利用.
- 从试点采访和五个重点小组的数据进行主题分析,其中包括33名初级护理护士和医生.
主要成果:
- ACKD患者的个人资料往往涉及老年,脆弱的个人,并发病症,复杂的诊断和管理.
- 专业环境因素,如时间限制,过度的电子健康记录和不熟悉的指导方针,阻碍了证据的使用.
- 专业人士认识到系统的局限性,但承认需要改善培训和与脏病学服务的协调.
结论:
- 心理因素,包括态度,主观规范和感知行为控制,显著阻碍基于证据的ACKD实施.
- 主观规范和感知行为控制被确定为应用临床实践指南和标准化记录的主要障碍.
- 优化ACKD管理需要多方面的策略,包括培训,态度,组织结构,IT系统和跨学科的护理协调.
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