脑卒中患者跨部门协调随访护理的过程评价:一项定性研究。

Q2 Medicine
Theresa Schrage, Claudia Glissmann, Götz Thomalla, David Leander Rimmele, Holger Schmidt, Michael Rosenkranz, Stefan Boskamp, Martin Härter, Levente Kriston
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引用次数: 0

摘要

背景:由于各种利益相关者的参与和卫生保健协调的挑战,实施干预措施以改善卒中随访护理是复杂的。本研究的目的是评估卒中患者实施跨部门、协调的随访护理(StroCare干预)的过程。方法:作为多中心介入试验的一部分,本定性研究采用前后设计,对患者和医护人员进行半结构化访谈。在8个参与的急性护理和康复诊所实施了多成分干预。访谈采用定性内容分析进行分析。内容采用八个先验定义的类别(可接受性、采用性、适当性、可行性、保真性、可持续性、以患者为中心、治疗满意度和与大流行相关的效果)进行编码,并可能归纳开发类别。结果:共访谈21例患者,访谈34例工作人员23例。除了演绎范畴外,还出现了三个归纳范畴(社会心理影响、相互联系和改进潜力)。干预前对可接受性、采用性和适宜性进行积极评价。但是,可行性差对采用和适当性产生了负面影响。相比之下,与患者护理相关的结果(以患者为中心和心理社会影响)与该效应无关。结论:与其他卒中护理干预的实施研究类似,StroCare项目中电子健康服务的实施在新软件的可用性和适应性方面遇到了障碍。然而,在以患者为中心、社会心理影响和患者总体受益方面的高采用率和适当性支持了剩余干预成分的继续。该试验在ClinicalTrials.gov (NCT04159324)上注册,注册日期为12/11/19。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Process evaluation of a cross-sectoral, coordinated follow-up care of stroke patients: a qualitative study.

Background: Implementation of interventions to improve follow-up stroke care is complex due to the involvement of various stakeholders and challenges of health care coordination. The aim of this study was to evaluate the process of implementing a cross-sectoral, coordinated follow-up care for stroke patients (the StroCare intervention).

Methods: As part of a multicenter interventional trial, this qualitative study was performed in a pre-post design with semi-structured interviews conducted with patients and health care employees. The multicomponent intervention was implemented in eight participating acute care and rehabilitation clinics. The interviews were analyzed using qualitative content analysis. Contents were coded using eight a priori defined categories (acceptability, adoption, appropriateness, feasibility, fidelity, sustainability, patient-centeredness, satisfaction with treatment, and pandemic-related effects) with the possibility of inductively developed categories.

Results: Interviews with 21 patients and 34 interviews with 23 employees were conducted. In addition to the deductive categories, three inductive categories (psychosocial implications, interconnectedness, and potential for improvement) emerged. Acceptability, adoption, and appropriateness were assessed positively before the intervention. However, poor feasibility had a negative impact on adoption and appropriateness. In contrast, outcomes related to patient care (patient-centeredness and psychosocial implications) were independent from this effect.

Conclusions: Similar to other implementation studies of stroke care interventions, implementation of eHealth Services in the StroCare project met barriers in usability and adaptability of new software. However, high adoption and appropriateness in regard to patient-centeredness, psychosocial implications, and an overall benefit for the patients supported continuation of the remaining intervention components. Trial registration The trial is registered at ClinicalTrials.gov (NCT04159324), registration date 12/11/19.

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来源期刊
CiteScore
7.40
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