组织气候和决策援助在狼护理中的可持续性:混合方法研究
Aizhan Karabukayeva1, Larry R Hearld2, Nathan W Carroll3
1Hudson College of Public Health, University of Oklahoma Health Sciences Center, 801 NE 13th St., Oklahoma City, OK, 73014, United States, 1 2055155146.
JMIR formative research
|August 21, 2025
概括
对于狼患者而言,当诊所相信他们能够管理变化时,数字决策辅助工具 (DAs) 更有可能持续存在. 然而,学习气候可能会阻碍这些数字健康工具的长期使用.
科学领域:
- 医疗信息学
- 患者参与
- 关节病学
背景情况:
- 数字决策辅助器 (DA) 支持系统性红斑狼 (SLE) 等复杂疾病的共同决策.
- 在临床实践中影响数字健康工具长期可持续性的组织因素的证据有限.
- 这项研究调查了组织气候对狼患者持续使用电子DA的作用.
研究的目的:
- 检查学习气候,变化准备和狼DA感知的持续性之间的关系.
- 在美国的15个不同类型的风湿病诊所评估这些因素.
主要方法:
- 同时设计混合方法,整合纵向定量调查和定性访谈.
- 在3个时间点 (6,12,24个月) 从204名临床工作人员收集的定量数据.
- 从36个半结构面试中获得的定性数据探讨了维持障碍.
主要成果:
- 临床的效率变化与感知到的DA持久性 (β=4. 00; P<. 001) 有积极的关联.
- 内部和外部学习气候与DA持久性负相关 (分别为β=-1.39;P<.05和β=-2.11;P<.01).
- 变革承诺在统计上没有显著意义; 定性数据显示工作流程和购买挑战.
结论:
- 维持数字健康工具需要一个支持性的组织环境,而不仅仅是技术整合.
- 临床的变化效率对于DA维持至关重要,而学习气候可能会构成障碍.
- 评估组织的准备和定制实施策略对于促进DA使用至关重要.
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