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卫生保健专业人员在实践中进行常规结果测量的障碍和促进因素:系统评价。

The barriers and facilitators to routine outcome measurement by allied health professionals in practice: a systematic review.

机构信息

NMAHP Research Unit, Iris Murdoch Building, University of Stirling, Stirling, FK9 4LA, Scotland, UK.

出版信息

BMC Health Serv Res. 2012 May 22;12:96. doi: 10.1186/1472-6963-12-96.

Abstract

BACKGROUND

Allied Health Professionals today are required, more than ever before, to demonstrate their impact. However, despite at least 20 years of expectation, many services fail to deliver routine outcome measurement in practice. This systematic review investigates what helps and hinders routine outcome measurement of allied health professionals practice.

METHODS

A systematic review protocol was developed comprising: a defined search strategy for PsycINFO, MEDLINE and CINHAL databases and inclusion criteria and systematic procedures for data extraction and quality appraisal. Studies were included if they were published in English and investigated facilitators and/or barriers to routine outcome measurement by allied health professionals. No restrictions were placed on publication type, design, country, or year of publication. Reference lists of included publications were searched to identify additional papers. Descriptive methods were used to synthesise the findings.

RESULTS

960 papers were retrieved; 15 met the inclusion criteria. Professional groups represented were Physiotherapy, Occupational Therapy, and Speech and Language Therapy. The included literature varied in quality and design. Facilitators and barriers to routine outcome measurement exist at individual, managerial and organisational levels. Key factors affecting professionals' use of routine outcome measurement include: professionals' level of knowledge and confidence about using outcome measures, and the degree of organisational and peer-support professionals received with a view to promoting their work in practice.

CONCLUSIONS

Whilst the importance of routinely measuring outcomes within the allied health professions is well recognised, it has largely failed to be delivered in practice. Factors that influence clinicians' ability and desire to undertake routine outcome measurement are bi-directional: they can act as either facilitators or barriers. Routine outcome measurement may only be deliverable if appropriate action is taken at individual therapist, team, and organisational levels of an organisation.

摘要

背景

如今,与健康相关的专业人员比以往任何时候都更需要展示其影响力。然而,尽管已经有至少 20 年的预期,但许多服务在实践中未能实现常规结果测量。本系统评价研究了有助于和阻碍与健康相关的专业人员实践的常规结果测量的因素。

方法

制定了系统评价方案,包括:针对 PsycINFO、MEDLINE 和 CINHAL 数据库的明确搜索策略,以及纳入标准和系统的数据提取和质量评估程序。如果研究报告以英文发表,并调查了与健康相关的专业人员常规结果测量的促进因素和/或障碍,则将其纳入。对出版物的类型、设计、国家和出版年份没有限制。纳入出版物的参考文献列表也被搜索,以确定其他论文。使用描述性方法综合研究结果。

结果

共检索到 960 篇论文,其中 15 篇符合纳入标准。代表的专业群体有物理治疗、职业治疗和言语和语言治疗。纳入的文献在质量和设计上存在差异。常规结果测量的促进因素和障碍存在于个人、管理和组织层面。影响专业人员常规结果测量使用的关键因素包括:专业人员对使用结果测量的知识和信心水平,以及组织和同行对专业人员工作的支持程度。

结论

虽然在与健康相关的专业人员中常规测量结果的重要性已得到广泛认可,但在实践中仍未能实现。影响临床医生进行常规结果测量的能力和意愿的因素是双向的:它们既可以成为促进因素,也可以成为障碍。只有在个人治疗师、团队和组织层面采取适当行动,常规结果测量才可能实现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/610a/3358245/61a18b953df3/1472-6963-12-96-1.jpg

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