在加纳对护士进行高血压管理与控制任务转移策略培训：一项混合方法研究。
Training nurses in task-shifting strategies for the management and control of hypertension in Ghana: a mixed-methods study.
作者信息
Gyamfi Joyce, Plange-Rhule Jacob, Iwelunmor Juliet, Lee Debbie, Blackstone Sarah R, Mitchell Alicia, Ntim Michael, Apusiga Kingsley, Tayo Bamidele, Yeboah-Awudzi Kwasi, Cooper Richard, Ogedegbe Gbenga
机构信息
New York University School of Medicine, NYU Langone Medical Center, New York, NY, 10016, USA.
School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
出版信息
BMC Health Serv Res. 2017 Feb 2;17(1):104. doi: 10.1186/s12913-017-2026-5.
BACKGROUND
Nurses in Ghana play a vital role in the delivery of primary health care at both the household and community level. However, there is lack of information on task shifting the management and control of hypertension to community health nurses in low- and middle-income countries including Ghana. The purpose of this study was to assess nurses' knowledge and practice of hypertension management and control pre- and post-training utilizing task-shifting strategies for hypertension control in Ghana (TASSH).
METHODS
A pre- and post- test survey was administered to 64 community health nurses (CHNs) and enrolled nurses (ENs) employed in community health centers and district hospitals before and after the TASSH training, followed by semi-structured qualitative interviews that assessed nurses' satisfaction with the training, resultant changes in practice and barriers and facilitators to optimal hypertension management.
RESULTS
A total of 64 CHNs and ENs participated in the TASSH training. The findings of the pre- and post-training assessments showed a marked improvement in nurses' knowledge and practice related to hypertension detection and treatment. At pre-assessment 26.9% of the nurses scored 80% or more on the hypertension knowledge test, whereas this improved significantly to 95.7% post-training. Improvement of interpersonal skills and patient education were also mentioned by the nurses as positive outcomes of participation in the intervention.
CONCLUSIONS
Findings suggest that if all nurses receive even brief training in the management and control of hypertension, major public health benefits are likely to be achieved in low-income countries like Ghana. However, more research is needed to ascertain implementation fidelity and sustainability of interventions such as TASSH that highlight the potential role of nurses in mitigating barriers to optimal hypertension control in Ghana.
TRIAL REGISTRATION
Trial registration for parent TASSH study: NCT01802372 . Registered February 27, 2013.
背景
加纳的护士在家庭和社区层面的初级卫生保健服务中发挥着至关重要的作用。然而，在包括加纳在内的低收入和中等收入国家，关于将高血压管理与控制工作转移给社区卫生护士的相关信息却十分匮乏。本研究的目的是利用加纳高血压控制任务转移策略（TASSH），评估护士在培训前后对高血压管理与控制的知识和实践情况。
方法
在TASSH培训前后，对64名社区卫生中心和地区医院的社区卫生护士（CHN）及在编护士（EN）进行了前后测调查，随后进行了半结构化定性访谈，以评估护士对培训的满意度、实践中的变化以及优化高血压管理的障碍和促进因素。
结果
共有64名CHN和EN参加了TASSH培训。培训前后评估结果显示，护士在高血压检测和治疗方面的知识和实践有了显著改善。在预评估中，26.9%的护士在高血压知识测试中得分达到80%或更高，而培训后这一比例显著提高至95.7%。护士们还提到，参与干预的积极成果包括人际沟通技巧和患者教育方面的改善。
结论
研究结果表明，在加纳等低收入国家，如果所有护士都接受哪怕是关于高血压管理与控制的简短培训，都可能带来重大的公共卫生效益。然而，还需要更多研究来确定诸如TASSH等干预措施的实施保真度和可持续性，这类措施凸显了护士在减轻加纳优化高血压控制障碍方面的潜在作用。
试验注册
TASSH母体研究的试验注册：NCT01802372。于2013年2月27日注册。
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