弥合沙加斯病管理的差距:在巴西的初级医疗保健系统中使用实施科学方法的混合方法研究"Implementa-Chagas/SaMi-Trop项目"
Carlos Henrique Valente Moreira1,2,3, Laura Azevedo3, Ariela Mota Ferreira4
1Division of HIV, Infectious Diseases, & Global Medicine- Zuckerberg San Francisco General Hospital, University of California, San Francisco, CA, USA.
Lancet regional health. Americas
|June 18, 2025
概括
改善巴西查加斯病 (ChD) 管理需要解决医疗保健专业人员的低意识和症状诊断问题. 包括教育和培训在内的量身定制的干预措施对于早期检测和全面护理融入初级医疗保健至关重要.
科学领域:
- 公共卫生 公共卫生
- 热带医学 热带医学
- 医疗保健管理的管理
背景情况:
- 查加斯病 (ChD) 是拉丁美洲一个重要的被忽视的热带疾病,影响数百万.
- 巴西的初级医疗保健系统尽管有可用的工具,但在慢性病查和治疗方面面临挑战.
- 低查和治疗率凸显了查加斯病管理中的关键差距.
研究的目的:
- 在初级医疗保健中确定查加斯病管理的障碍和促进因素.
- 提出将查加斯病服务纳入常规医疗保健操作的战略.
- 提高医疗保健专业人员对查加斯病有效护理的能力.
主要方法:
- 使用了一种探索性的顺序混合方法方法.
- 员工聚焦小组,深入访谈和与医疗保健专业人员的定量调查.
- 应用了理论领域框架 (TDF) 和COM-B模型进行分析,使用行为变化轮 (BCW) 开发的干预措施.
主要成果:
- 关键障碍包括医疗保健专业人员对冠状动脉疾病的认识有限以及依赖症状诊断.
- 环境限制和公共/专业参与不足也阻碍了管理.
- 拟议的干预措施重点是教育,培训和基础设施改进,以提高初级保健能力.
结论:
- 倡导转向早期干预和查加斯病综合治疗的范式转变.
- 强调以团队为基础的战略与世卫组织的NTD路线图相一致,特别是在偏远地区.
- 旨在克服医疗保健工作者面临的挑战,以积极主动和知情地管理查加斯病.
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