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农村和偏远地区专职医疗人员参与专职医疗农村和偏远地区培训与支持(AHRRTS)项目的障碍与促进因素:一项定性描述性研究

Barriers to, and enablers of, participation in the Allied Health Rural and Remote Training and Support (AHRRTS) program for rural and remote allied health workers: a qualitative descriptive study.

作者信息

Ducat Wendy H, Burge Vanessa, Kumar Saravana

机构信息

International Centre for Allied Health Evidence, School of Health Sciences, University of South Australia, Adelaide, Australia.

出版信息

BMC Med Educ. 2014 Sep 19;14:194. doi: 10.1186/1472-6920-14-194.

Abstract

BACKGROUND

Allied health professionals play a critical role in enhancing health outcomes in primary and tertiary settings. Issues affecting the recruitment and retention of allied health workers in rural and remote areas are multifactorial. Access to relevant and effective continuing professional development is argued to be a recruitment and retention strategy for health professionals in non-metropolitan areas, however trial of the effectiveness of professional development programs and identification of enablers and barriers to participation is needed. The Allied Health Rural and Remote Training and Support (AHRRTS) program aimed to provide an integrated program of education and professional support activities for allied health professionals working within Queensland Health in rural and remote locations. The aim of this study was to explore enablers and barriers to access to, and effective participation in, the AHRRTS program from various allied heath stakeholders' perspectives.

METHODS

A qualitative descriptive study utilising semi-structured interviews with various allied heath stakeholders was undertaken. The interview questions focussed on a number of issues pertinent to AHRRTS program, with specific probing questions regarding barriers and enablers to participation in the AHRRTS program. The interviews were then transcribed verbatim and analysed using thematic analysis.

RESULTS

Using purposive sampling, a total of 55 stakeholders were interviewed for this study. Time, organisational factors and travel were identified as common barriers and organisational factors, travel and presentation modes were identified as common enablers. Interestingly, some of these factors act as barriers and/or enablers highlighting that these are essentially two sides of the same coin. The findings suggest that while it is important to have policies and procedures for ongoing support of allied health professionals, it should be complemented by enabling strategies to address persistent barriers.

CONCLUSION

The study suggests that while a program such as AHRRTS is accessible and facilitates participation in a number of ways, significant barriers to participation continue to persist at the coal face. Addressing these barriers will require a targeted, multifaceted approach. Lessons from this study provide unique insights into factors which influence the successful implementation and sustainability of recruitment and retention initiatives for rural and remote allied health workers.

摘要

背景

专职医疗专业人员在改善初级和三级医疗机构的健康状况方面发挥着关键作用。影响农村和偏远地区专职医疗人员招聘和留用的问题是多方面的。有人认为,获得相关且有效的持续专业发展是吸引和留住非大都市地区医疗专业人员的一项策略,然而,需要对专业发展计划的有效性进行试验,并确定参与的促进因素和障碍。农村和偏远地区专职医疗培训与支持(AHRRTS)计划旨在为昆士兰卫生部门在农村和偏远地区工作的专职医疗专业人员提供一个综合的教育和专业支持活动计划。本研究的目的是从不同专职医疗利益相关者的角度探讨参与AHRRTS计划的促进因素和障碍。

方法

采用定性描述性研究方法,对不同专职医疗利益相关者进行半结构化访谈。访谈问题集中在与AHRRTS计划相关的一些问题上,特别询问了参与AHRRTS计划的障碍和促进因素。访谈内容随后逐字转录,并采用主题分析法进行分析。

结果

采用目的抽样法,本研究共访谈了55名利益相关者。时间、组织因素和交通被确定为常见障碍,而组织因素、交通和授课方式被确定为常见促进因素。有趣的是,其中一些因素既可以是障碍,也可以是促进因素,这表明它们本质上是同一枚硬币的两面。研究结果表明,虽然制定政策和程序以持续支持专职医疗专业人员很重要,但还应辅以应对持续存在障碍的促进策略。

结论

该研究表明,虽然像AHRRTS这样的计划易于参与,并在许多方面促进了参与,但在实际操作层面,参与仍存在重大障碍。解决这些障碍需要有针对性的多方面方法。本研究的经验教训为影响农村和偏远地区专职医疗人员招聘和留用计划成功实施及可持续性的因素提供了独特见解。

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