从政策到实践:关于医疗保健改革和前线保留的定性研究
Anik Dubé1, Stéphanie Collin1, Jennifer Hakim2
1Université de Moncton, NB, Canada.
概括
医疗保健改革影响农村,法语少数民族社区的护士和医生保留. 地方自治和响应能力是关键,而失去控制阻碍了提供优质护理.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 农村卫生 农村卫生
- 少数民族语言卫生系统
背景情况:
- 加拿大医疗保健改革创建了一个由省级和区域卫生当局 (RHA) 组成的两级系统.
- 新不伦瑞克的一个RHA服务于法语农村少数民族社区,他们面临着独特的挑战.
- 在这种情况下,了解影响医疗保健专业人员保留的因素至关重要.
研究的目的:
- 探索影响在语言少数群体背景下运行的RHA中护士和医生的保留的关键因素.
- 检查宏观层面的医疗保健政策决策如何在医疗保健提供的前线体验.
主要方法:
- 采用了一种描述性的定性研究设计.
- 数据收集涉及21名医生和37名注册护士的半结构面试.
- 用20个关键信息提供者的焦点小组和专题分析来确定关键主题.
主要成果:
- 出现了三个主要因素:组织问责制和丧,地方自治和上下文响应,以及开放的文化与感知失去控制.
- 这些因素与影响运营设置和资源分配的政策变化有关.
- 脱离决策层次和感觉失去控制被认为是质量护理的障碍.
结论:
- 医疗保健系统的政策调整对前线护理和专业人员的留守有直接影响.
- 支持充足的资源和促进专业参与对于成功的系统级变化至关重要.
- 提高工作满意度和解决对控制的担忧对于在少数群体背景下保留护士和医生至关重要.
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