Shi Jianwei, Jiang Chenghua, Tan Duxun, Yu Dehua, Lu Yuan, Sun Pengfei, Pan Ying, Zhang Hanzhi, Wang Zhaoxin, Yang Beilei
Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, China; Tongji University School of Medicine, Shanghai 200092, China.
Tongji University School of Medicine, Shanghai 200092, China.
Biomed Res Int. 2016;2016:2694030. doi: 10.1155/2016/2694030. Epub 2016 Aug 14.
Objective. Existing research shows a serious scarcity of EBPH practice in China and other developing regions; as an exploratory study, this study aimed to assess the current EBPH implementation status in Shanghai of China qualitatively. Methods. Using semistructured key informant interviews, we examined the status of and impediments to the lagging EBPH in China. Data were analyzed based on the Consolidated Framework for Implementation Research (CFIR). Results. Chinese public health practitioners knew more about evidence-based medicine but less about EBPH. The situation was worse in community healthcare centers. Participants perceived that evidence sources were limited and the quality of evidence was low. Concerning the inner setting factors, the structural characteristics, networks and communications, implementation climate, and leadership engagement were confronted with many problems. Among the outer setting factors, external government policies and incentives and low patient compliance were the key problems. Additionally, public health practitioners in Shanghai lacked sufficient awareness of EBPH. Furthermore, the current project-based EBPH lacks a systematic implementation system. Conclusions. Existing practical perspectives on EBPH indicate a lag in the advocacy of this new ideology in China. It would be advisable for healthcare institutions to take the initiative to explore feasible and multiple methods of EBPH promotion.
目的。现有研究表明,中国及其他发展中地区循证公共卫生实践严重匮乏;作为一项探索性研究,本研究旨在对中国上海循证公共卫生实践的当前实施状况进行定性评估。方法。通过半结构化关键信息人访谈,我们考察了中国循证公共卫生实践滞后的现状及障碍因素。基于实施研究整合框架(CFIR)对数据进行分析。结果。中国公共卫生从业者对循证医学了解较多,但对循证公共卫生实践了解较少。社区卫生服务中心的情况更糟。参与者认为证据来源有限且证据质量较低。在内部环境因素方面,结构特征、网络与沟通、实施氛围以及领导参与存在诸多问题。在外部环境因素中,政府外部政策与激励措施以及患者依从性低是关键问题。此外,上海的公共卫生从业者对循证公共卫生实践缺乏足够的认识。此外,当前基于项目的循证公共卫生实践缺乏系统的实施体系。结论。循证公共卫生实践的现有实践观点表明,这种新观念在中国的倡导方面存在滞后。医疗机构应主动探索可行的、多种循证公共卫生实践推广方法。