心血管危险因素指南的教育实施方案:熟悉度、使用和态度变化的分析

Risto Kuronen, P. Jallinoja, Riitta Airola, K. Patja
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引用次数: 4

摘要

目的探讨在实施计划前后,自我报告的心血管风险(高血压、血脂异常、成人肥胖和戒烟)指南熟悉度和使用情况的变化,以及对临床指南的一般态度,以及参加指南培训与对指南的态度和使用之间的关系。背景当前的护理指南为心血管危险因素的管理提供了一个有用的工具。护士使用循证护理和指南的时间比医生短。方法在指南实施方案VALTIT前后,向芬兰南部拥有21万居民的Päijät-Häme卫生和社会保健区所有初级卫生保健护士和医生发送一份自我管理的问卷。主要结果测量是自我报告对心血管风险指南的熟悉程度和使用情况,以及测量对临床指南态度的项目。护士对所有指南的熟悉程度均有所增加,但仅对血脂异常指南的使用有所增加。在护士中,参与指南培训与指南使用之间存在关联。据报告,在研究期间,医生对成人肥胖指南的熟悉程度和使用程度有所增加。报告说他们被要求使用指南的护士和医生的比例增加了。护士对采纳指导方针的准备程度的看法发生了积极的变化,参加至少一次培训活动的护士的看法更为积极。结果是令人鼓舞的熟悉指导方针。在使用方面,我们的研究结果表明,两年的计划可能不足以改变有关生活方式改变相关指南的根深蒂固的做法和态度。挑战在于多专业实施心血管风险指南,特别强调改变生活方式作为一种治疗选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Educational implementation programme of guidelines on cardiovascular risk factors: an analysis of changes in familiarity, use and attitudes
Aim To explore changes in self-reported familiarity and use of guidelines dealing with cardiovascular risks (hypertension, dyslipidemia, adult obesity and smoking cessation) and general attitudes towards clinical guidelines before and after implementation programme, as well as the association of guideline training attendance and attitudes towards and use of guidelines. Background The current care guidelines provide a useful tool in the management of cardiovascular risk factors. Evidence-based care and guideline use have a shorter tradition among nurses than among physicians. Methods A self-administered questionnaire was sent to all primary health care nurses and physicians in Päijät-Häme Health and Social Care District, an area of 210 000 inhabitants in Southern Finland, before and after the guideline implementation programme VALTIT. Findings Main outcome measures were self-reported familiarity with and use of guidelines on cardiovascular risks and items measuring attitudes towards clinical guidelines. Among nurses, the reported familiarity with all the guidelines increased, but increase in use occurred only in respect of the dyslipidemia guideline. Among nurses, there was an association between participation in guideline training and guideline use. Physicians’ reported familiarity with and use of the adult obesity guideline increased during the study period. The proportion of nurses and physicians who reported that they had been asked to use the guidelines increased. Perceptions concerning the readiness to adopt the guidelines changed positively among nurses and were more positive among those attending at least one training event. Results are encouraging regarding familiarity with guidelines. Regarding usage our results suggest that a two-year programme might not be enough to alter the deep-rooted practices and attitudes concerning lifestyle change related guidelines. The challenge lies in multi-professional implementation of guidelines on cardiovascular risks with special emphasis on lifestyle change as a treatment option.
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