夸祖鲁-纳塔尔省初级卫生保健改善慢性肾脏疾病管理指南的建议。

Verosha Ramkelawan, Pretty N Mbeje, Ntombifikile G Mtshali
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引用次数: 0

摘要

背景:慢性肾脏疾病(CKD)在夸祖鲁-纳塔尔省(KZN)的患病率很高,特别是在有艾滋病毒、糖尿病和高血压等危险因素的个体中。尽管有现有的指导方针,但该研究确定了在初级卫生保健(PHC)层面实施CKD管理措施的多因素差距。这导致了晚期诊断,并增加了高等教育机构的负担,这一点在院校统计中得到了证实。因此,这项研究是在四个不同的环境中进行的:德班的一家三级医院和KZN的三个初级保健中心(两个城市中心和一个乡镇中心)。目的:该研究的目的是描述在南非KZN的PHC环境中,医疗保健专业人员对CKD管理的看法。方法:采用质性、探索性设计,涉及卫生保健专业人员。采用有目的的抽样。采用开放编码和常规内容分析对数据进行分析。结果:调查结果揭示了三个总体主题:(1)对现有指南的了解和认识;(2)系统碎片化,缺乏明确的指南;(3)明确的指南对患者护理的影响。参与者表现出对指导方针的不同认识,显示出继续教育的必要性。与会者表示需要继续教育和明确的指导方针。结论:该研究强调了迫切需要弥合知识差距,建立一个有凝聚力的医疗体系,以有效地解决KZN日益增长的CKD负担。贡献:该研究强调了实施明确的指导方针以改善患者预后、早期发现和适当干预的潜在益处,从而减轻三级医疗机构的负担。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Recommendation to improve chronic kidney disease management guideline in primary healthcare, KwaZulu-Natal.

Background:  The prevalence of chronic kidney disease (CKD) is high in KwaZulu-Natal (KZN), especially in individuals with risk factors such as HIV, diabetes mellitus and hypertension. Despite existing guidelines, the study identified multifactorial gaps in implementing CKD management measures at the primary healthcare (PHC) level. This leads to late-stage diagnoses and increased burdens on tertiary institutions, as identified in institutional statistics. The study was therefore conducted in four different settings: a tertiary hospital in Durban and three PHC centres across KZN (two urban centres and one in a township).

Objectives:  The study's objective is to describe the perceptions of healthcare professionals on the management of CKD, in the PHC setting in KZN, South Africa.

Method:  A qualitative, exploratory design involving healthcare professionals was adopted. Purposeful sampling was used. Open coding and conventional content analysis were adopted to analyse data.

Results:  Findings revealed three overarching themes: (1) knowledge and awareness about existing guidelines, (2) fragmented system and a lack of clear guidelines and (3) implications of clear guidelines on patient care. Participants demonstrated diverse awareness of guidelines, revealing a need for continuous education. Participants expressed needs for continuous education and clear guidelines.

Conclusion:  The study highlights an urgent need to bridge the knowledge gap and establish a cohesive healthcare system to address the growing CKD burden in KZN effectively.Contribution: The study emphasises the potential benefits of implementing clear guidelines to improve patient outcomes, early detection and appropriate interventions, thereby reducing the burden on tertiary facilities.

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