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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, PO Box 1377, Broome, Western Australia 6725, Australia.
概括
改善澳大利亚原住民获得移植的机会,需要解决吸烟和坚持治疗问题的临时禁忌. 患者的支持和教育对于成功的移植至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植免疫学 移植免疫学
- 公共卫生 公共卫生
背景情况:
- 末期病不成比例地影响澳大利亚原住民和托雷斯海峡岛民.
- 在这些社区获得移植的机会方面存在显著的差异.
- 适合性评估是移植途径的关键初步步骤.
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.
- 评估原住民社区控制脏服务中的所有患者.
- 确定临时的禁忌,以指导医疗服务的改进.
- 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,对参与者经验进行主题分析.
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 (23/46),治疗坚持 (17/46) 和高BMI (11/46).
- 患者希望获得更多关于可修改风险因素的信息和支持,以提高移植资格.
结论:
- 一种CQI方法成功地提高了适合性评估,并确定了原住民患者的关键障碍.
- 调查结果强调了需要文化适当的教育和支持,涉及土著工作人员和患者.
- 解决可修改因素对于改善等待名单和移植准入至关重要.
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