共同设计一项初级医疗干预措施,以改善阿根廷门多萨的糖尿病护理:一个定性案例研究
Javier Roberti1,2, Agustina Mazzoni2, Marina Guglielmino2
1CIESP- CONICET, Buenos Aires, Argentina.
概括
与初级医疗保健 (PHC) 中的患者和提供者共同设计干预措施可以克服慢性疾病管理中的挑战. 这种方法产生了可行的策略,以改善阿根廷的糖尿病护理.
科学领域:
- 公共卫生 公共卫生
- 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:
- 低收入和中等收入国家的初级医疗保健 (PHC) 由于系统碎片化和资源限制,在慢性疾病管理方面扎.
- 阿根廷针对非传染性疾病的国家战略面临分散治理的实施障碍,造成护理差距.
- 这项研究的重点是编码设计的干预措施,以加强在门多萨的PHC系统内的糖尿病护理.
研究的目的:
- 描述一个与背景相关的干预措施的代码设计过程,以加强初级医疗保健中的糖尿病护理.
- 通过利益相关者的协作,确定系统性障碍和可行的实施策略.
- 开发一个以患者为中心的干预方案,以满足阿根廷门多萨的当地需求.
主要方法:
- 一种定性案例研究方法利用了参与患者,医疗保健提供者和决策者的共同设计研讨会.
- 方法包括用户旅程映射,世界咖啡馆和优先级练习,以实施研究逻辑模型和规范化过程理论为指导.
- 通过反射主题分析分析了研讨会活动的数据.
主要成果:
- 参与者 (n=38) 发现了系统性障碍,如资源不足,协调不良和患者获取问题.
- 创意练习促进了协作和解决问题的能力,从而形成了一个代码设计的干预方案,强调了多维战略和利益相关者协作.
- 建议的策略包括社区资产映射,社会处方,受保护的预约时间,以及数字化患者记录.
结论:
- 一个结构化的代码设计过程,以理论为基础,有效地支持开发特定背景的干预措施,以改善PHC.
- 研讨会有助于确定可行的实施策略,反映了利益相关者的不同观点.
- 代码设计方法是可行的,受到好评,并为其他环境中的类似举措提供了有价值的见解.
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