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肥胖症诊疗指南的翻译:测量与评估

Translation of obesity practice guidelines: measurement and evaluation.

作者信息

Erickson Kristin J, Monsen Karen A, Attleson Ingrid S, Radosevich David M, Oftedahl Gary, Neely Claire, Thorson Diane R

机构信息

Health Initiatives and Evaluation, Otter Tail County Public Health and PartnerSHIP 4 Health, Fergus Falls, Minnesota.

School of Nursing Affiliate Faculty, Institute for Health Informatics, University of Minnesota School of Nursing, Minneapolis, Minnesota.

出版信息

Public Health Nurs. 2015 May-Jun;32(3):222-31. doi: 10.1111/phn.12169. Epub 2014 Nov 26.

Abstract

OBJECTIVE(S): A public health nurse (PHN) in the Midwestern United States (U.S.) led a collaborative system-level intervention to translate the Institute of Clinical Systems Improvement (ICSI) Adult Obesity Guideline into interprofessional practice. This study (1) evaluated the extent of guideline translation across organizations and (2) assessed the Omaha System as a method for translating system-level interventions and measuring outcomes.

DESIGN AND SAMPLE

This retrospective, mixed methods study was conducted with a purposeful sample of one administrator (n = 10) and two to three clinicians (n = 29) from each organization (n = 10).

MEASURES

Omaha System Problem Rating Scale for Outcomes Knowledge, Behavior, and Status (KBS). KBS ratings gathered from semi-structured interviews and Omaha System documentation were analyzed using standard descriptive and inferential statistics and triangulated findings with participant quotes.

RESULTS

KBS ratings and participant quotes revealed intervention effectiveness in creating sustained system-level changes. Self-reported and observed KBS ratings demonstrated improvement across organizations. There was moderate to substantial agreement regarding benchmark attainment within organizations. On average, self-reported improvement exceeded observer improvement.

CONCLUSIONS

System-level PHN practice facilitator interventions successfully translated clinical obesity guidelines into interprofessional use in health care organizations. The Omaha System Problem Rating Scale for Outcomes reliably measured system-level outcomes.

摘要

目的

美国中西部的一名公共卫生护士(PHN)领导了一项协作性的系统层面干预措施,将临床系统改进研究所(ICSI)的成人肥胖指南转化为跨专业实践。本研究(1)评估了各组织间指南转化的程度,(2)评估了奥马哈系统作为一种转化系统层面干预措施和衡量结果的方法。

设计与样本

本回顾性混合方法研究采用了有目的抽样,从每个组织(n = 10)中选取一名管理人员(n = 10)和两到三名临床医生(n = 29)。

测量方法

奥马哈系统结果知识、行为和状态问题评定量表(KBS)。从半结构化访谈和奥马哈系统文档中收集的KBS评分,采用标准描述性和推断性统计方法进行分析,并与参与者的引述进行三角互证。

结果

KBS评分和参与者引述显示干预措施在产生持续的系统层面变化方面是有效的。自我报告和观察到的KBS评分表明各组织均有改善。各组织内部在达到基准方面存在中度到高度的一致性。平均而言,自我报告的改善超过了观察者报告的改善。

结论

系统层面的公共卫生护士实践促进干预措施成功地将临床肥胖指南转化为医疗保健组织中的跨专业应用。奥马哈系统结果问题评定量表能够可靠地衡量系统层面的结果。

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