探索产后试验证据的实施:与临床医生和临床学者进行的定性研究
Fiona Cross-Sudworth1, Nimarta Dharni2, Sara Kenyon2
1Applied Health Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. f.cross-sudworth@bham.ac.uk.
Implementation science communications
|September 28, 2024
概括
关于分娩位置和疼痛缓解的研究结果在英国产科单位没有得到广泛的实施. 竞争的优先事项和资源限制阻碍了采用,尽管确定了培训和领导力支持等促进者.
科学领域:
- 产科和妇科 产科和妇科
- 医疗保健 实施 科学 科学
- 改善临床实践的改善
背景情况:
- 将研究证据转化为临床实践仍然是一个重大挑战.
- 这项研究研究了两个产后干预措施的实施:BUMPES试验 (第二阶段分娩位置) 和RESPITE试验 (患者控制的Remifentanil止痛).
研究的目的:
- 探索英国孕产妇环境中的BUMPES和RESPITE产妇试验的实施促进因素和障碍.
- 了解临床医生和研究人员对采用这些基于证据的干预措施的观点.
主要方法:
- 在英国国家卫生服务信托基金和大学中进行了一项定性采访研究.
- 有目的和雪球采样招募了调查人员和产后护理临床医生 (助产士,麻醉师,产科医生).
- 半结构化的虚拟面试使用能力机会动机行为变化框架进行了主题分析.
主要成果:
- 来自19个产科的29名参与者接受了采访;大多数人都知道这些试验.
- 在4/19个单位实施了BUMPES,在3/19个单位实施了RESPITE,在试验场外的应用有限.
- 促进者包括资源,培训,领导力支持和传播;障碍物包括临床医生的反对和竞争优先事项.
结论:
- 尽管有令人信服的发现,但BUMPES和RESPITE的广泛实施并未实现.
- 与大规模改进计划和国家指导方针相比,单项试验的影响可能有限.
- 鉴于劳动力限制,资源有限以及产妇护理的众多竞争需求,优先考虑干预实施至关重要.
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