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支持在偏远的西澳大利亚地区公平获得移植,使用持续的质量改进
Felicity Stewart1, Nicholas Corsair1, James Stacey1
1Kimberley Renal Services, Broome, Western Australia, Australia.
概括
改善土著人获得移植的机会,需要解决吸烟和坚持治疗等暂时的禁忌. 适应性评估的持续质量改进 (CQI) 是成功等待列表的关键.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 澳大利亚原住民和托雷斯海峡岛民患有末期脏疾病的人口在脏移植获得方面存在显著差异.
- 脏移植的旅程包括在等候名单活动之前进行关键的初步适合性评估.
- 在土著社区控制的脏服务中,解决这些接入障碍至关重要.
研究的目的:
- 实施持续质量改进 (CQI) 方法用于移植适合性评估.
- 评估服务内的所有患者是否适合移植.
- 确定关键的临时禁忌,以专注于改善卫生服务.
- 探索患者在适应性评估过程中的经验.
- 为金伯利脏服务提供移植前和移植后护理模式的信息.
主要方法:
- 混合方法设计,包括文件审查.
- 对移植适合性评估结果的描述性分析.
- 半结构面试与专题分析,以探索患者的经验.
主要成果:
- 30%的评估没有显示任何禁忌;64%有临时禁忌;6%有永久禁忌.
- 最常见的临时禁忌包括吸烟 (49%),治疗坚持 (36%) 和高体重指数 (24%).
- 患者希望了解更多关于移植过程的信息,并支持可修改的风险因素.
结论:
- 一种CQI方法成功地提高了金伯利土著人的适合性评估.
- 确定了临时的禁忌,为改善等待列表的成功提供了重点.
- 让原住民工作人员和患者参与教育和支持对于潜在的移植接受者来说至关重要.
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