成功实施社会处方,以实现嵌入:什么有效,为谁,在什么情况下? 一个快速的现实主义审查
C Bos1,2, E de Weger3, I Wildeman4
1National Institute for Public Health and the Environment (RIVM), Centre for Public Health, Care and Society, Department of health and Care Nationally, P.O. Box 1, Bilthoven, 3720 BA, The Netherlands. Cheryl.bos@rivm.nl.
BMC public health
|July 9, 2024
概括
社会处方 (SP) 通过将客户与社区服务联系起来,有助于解决更广泛的健康需求. 嵌入SP需要系统和文化转变,重点关注意识,信任,链接人员能力,客户支持和资源对齐.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 健康的社会决定因素
背景情况:
- 医疗保健系统往往难以解决影响客户健康的更广泛决定因素.
- 社会处方 (SP) 将初级保健客户与社会,社区和志愿服务联系起来,以满足更广泛的需求.
- 现有的研究提供了对SP早期实施的见解,但缺乏将SP纳入实践的指导.
研究的目的:
- 确定成功嵌入社会规范 (SP) 的指导原则.
- 确定影响SP实施向嵌入的上下文因素和机制.
- 为旨在整合SP的医疗保健组织提供可操作的见解.
主要方法:
- 使用快速现实主义审查来探索"什么是有效的,为谁,为什么,在哪些背景下".
- 一个由健康和护理组织组成的荷兰当地参考小组提供了研究问题和上下文相关性的信息.
- 与参考小组举行的研讨会促进了对国际发现的解释,以便在当地应用.
主要成果:
- 确定了嵌入SP的五个指导原则:提高认识,建立信任的利益相关者关系,投资于链接人员能力,确保客户自力更生,并调整跨部门结构和资源.
- 对于更广泛的健康决定因素和SP的作用的认识是至关重要的.
- 信任关系和利益相关者之间的循环推过程对于SP的成功至关重要.
结论:
- 嵌入社会规范需要结构性,系统层面的变化和文化转变.
- 需要改变医疗保健专业人员和客户对SP价值的态度.
- 让社区参与并纳入他们的观点对于政策制定者和研究人员在推进SP方面至关重要.
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