Phillips Jane L, Rolley John X, Davidson Patricia M
School of Nursing, The University of Notre Dame Australia, The Cunningham Centre for Palliative Care, St Vincent's & Mater Health Sydney, 170 Darlinghurst Road, Sydney, NSW 2010, Australia.
Nurs Res Pract. 2012;2012:279431. doi: 10.1155/2012/279431. Epub 2012 Jul 17.
Aims and Objectives. This paper provides an overview of the applicability of the PRECEDE-PROCEED Model to the development of targeted nursing led chronic illness interventions. Background. Changing health care practice is a complex and dynamic process that requires consideration of social, political, economic, and organisational factors. An understanding of the characteristics of the target population, health professionals, and organizations plus identification of the determinants for change are also required. Synthesizing this data to guide the development of an effective intervention is a challenging process. The PRECEDE-PROCEED Model has been used in global health care settings to guide the identification, planning, implementation, and evaluation of various health improvement initiatives. Design. Using a reflective case study approach, this paper examines the applicability of the PRECEDE-PROCEED Model to the development of targeted chronic care improvement interventions for two distinct Australian populations: a rapidly expanding and aging rural population with unmet palliative care needs and a disadvantaged urban community at higher risk of cardiovascular disease. Results. The PRECEDE-PROCEED Model approach demonstrated utility across diverse health settings in a systematic planning process. In environments characterized by increasing health care needs, limited resources, and growing community expectations, adopting planning tools such as PRECEDE-PROCEED Model at a local level can facilitate the development of the most effective interventions. Relevance to Clinical Practice. The PRECEDE-PROCEED Model is a strong theoretical model that guides the development of realistic nursing led interventions with the best chance of being successful in existing health care environments.
目的。本文概述了“教育-环境诊断与评价-教育与生态发展-实施-评价（PRECEDE-PROCEED）模式”在以护理为主导的针对性慢性病干预措施制定中的适用性。背景。改变医疗保健实践是一个复杂且动态的过程，需要考虑社会、政治、经济和组织因素。还需要了解目标人群、卫生专业人员和组织的特征，并确定变革的决定因素。综合这些数据以指导有效干预措施的制定是一个具有挑战性的过程。PRECEDE-PROCEED模式已在全球医疗保健环境中用于指导各种健康改善举措的识别、规划、实施和评价。设计。本文采用反思性案例研究方法，探讨PRECEDE-PROCEED模式在为澳大利亚两个不同人群制定针对性慢性病护理改善干预措施方面的适用性：一个快速增长且老龄化的农村人口，其姑息治疗需求未得到满足；以及一个处于心血管疾病高风险的弱势城市社区。结果。PRECEDE-PROCEED模式方法在系统规划过程中显示出在不同健康环境中的效用。在医疗保健需求不断增加、资源有限且社区期望不断提高的环境中，在地方层面采用PRECEDE-PROCEED模式等规划工具可以促进最有效干预措施的制定。与临床实践的相关性。PRECEDE-PROCEED模式是一个强大的理论模型，可指导制定切实可行的、以护理为主导的干预措施，在现有医疗保健环境中取得成功有最大的机会。
