减少过度使用甲状腺功能测试的障碍和促进因素:混合方法研究
Annabel Jane Chapman1, Aneesa Khan2, Jordyn Thompson2
1Department of Anesthesiology, Pharmacology and Therapeutics, Therapeutics Initiative, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada.
BMJ quality & safety
|October 5, 2025
概括
过度使用甲状腺功能测试源于患者的期望,知识差距和系统问题. 干预措施应侧重于教育,反和改进实验室订购流程,以促进适当的测试.
科学领域:
- 内分泌学 在内分泌学.
- 医疗保健服务研究 医疗服务研究
- 实施科学 实施科学
背景情况:
- 甲状腺功能实验室测试经常被过度使用.
- 了解障碍和促进因素对于制定有效的撤销实施策略至关重要.
研究的目的:
- 探索适当的甲状腺功能测试的障碍和促进因素.
- 为制定量身定制的退出实施干预措施提供信息.
主要方法:
- 在加拿大不列颠哥伦比亚省使用调查和焦点小组进行混合方法研究 (2023年6月至10月).
- 用描述性统计数据分析的定量数据.
- 使用总结性内容分析和主题分析分析的定性数据.
- 使用的框架:综合理论领域框架和能力,机会,动机-行为模型.
主要成果:
- 确定了障碍:患者的期望 (症状,互联网搜索,替代提供者),从业者的知识差距 (测试解释,查频率) 和卫生系统因素 (时间,提供者的可用性,现有流程).
- 促进者确定了:教育资源 (从业者和患者),改进的健康信息系统,反射测试和个性化反.
- 调查响应率为1.4% (230名从业者);53名从业者参加了六个重点小组.
结论:
- 干预措施应整合可访问的医生教育和反,患者材料和优化的实验室订购系统.
- 未来的研究应该集中在开发和评估这些干预组件在不列颠哥伦比亚省.
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