Kapiriri Lydia, Bondy Susan J
University of Toronto Joint Centre for Bioethics, 88 College Street, Toronto, Ont., Canada M5G 1L4.
Int J Med Inform. 2006 Oct-Nov;75(10-11):714-21. doi: 10.1016/j.ijmedinf.2005.10.003. Epub 2005 Dec 15.
Access to reliable information is the most cost-effective and achievable strategy for sustainable improvement in health care. While several studies have described practitioners' information seeking behavior in developed countries, literature from developing countries is lacking. The aims of the study were: (i) to determine the most influential type of information for health workers' and planners' decision making; (ii) to establish the practitioners' evaluation of the availability and quality of this important information; and (iii) to establish the most commonly used/accessible sources of the information relevant for decision making in Uganda.
Self-administered questionnaires were sent to 610 health workers, planners, and administrators at the national, district and health facility levels in four districts in Uganda. Respondents were reminded three times, after which non-response was registered. Data were entered, cleaned and analysed using SPSS version 12.0. Logistic regression analysis was used to test for differences in responses.
The response rate was 67.7% (413). The respondents indicated that personal experience (79%), discussion with colleagues (76%) and national policy and treatment guidelines (75%) were most influential when making decisions in health care and planning. They reported that most of the epidemiological information was available and of relatively good quality but there was lack of information about distribution of benefit, segregated demographic data, and social values. The most often used sources of information included; discussions with colleagues (89%), doctors' statements (85%) and text books (77%). The least frequently used sources were the internet and the library. This varied with respondents' designation and region of origin.
Health planners and practitioners lack some of the information relevant for decision making. They tend to rely on the national policy and treatment guidelines, discussion with colleagues, and personal experience. Most frequently used sources of information are similar to previous studies. The variation in the frequency of use of the different sources of research information necessitates research to understand the barriers and careful planning of health information delivery to ensure equitable access.
获取可靠信息是实现医疗保健可持续改善的最具成本效益且切实可行的策略。虽然已有多项研究描述了发达国家从业者的信息寻求行为,但发展中国家的相关文献却较为匮乏。本研究的目的是:(i)确定对卫生工作者和规划者决策最具影响力的信息类型;(ii)了解从业者对这类重要信息的可得性和质量的评估;(iii)确定乌干达决策相关信息最常用/可获取的来源。
向乌干达四个地区国家、地区和卫生机构层面的610名卫生工作者、规划者及管理人员发放了自填式问卷。对受访者进行了三次提醒,之后记录未回复情况。使用SPSS 12.0版本录入、清理和分析数据。采用逻辑回归分析检验回复差异。
回复率为67.7%(413份)。受访者表示,个人经验(79%)、与同事的讨论(76%)以及国家政策和治疗指南(75%)在医疗保健和规划决策中最具影响力。他们报告称,大多数流行病学信息可得且质量相对较好,但缺乏关于效益分配、分类人口数据和社会价值观的信息。最常用的信息来源包括:与同事的讨论(89%)、医生的陈述(85%)和教科书(77%)。最不常用的来源是互联网和图书馆。这因受访者的职位和原籍地区而异。
卫生规划者和从业者缺乏一些与决策相关的信息。他们倾向于依赖国家政策和治疗指南、与同事的讨论以及个人经验。最常用的信息来源与先前研究相似。不同研究信息来源使用频率的差异需要开展研究以了解障碍,并精心规划卫生信息传递,以确保公平获取。