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瑞典职业健康服务中循证实践的发展:对态度、障碍和促进因素的3年随访

Development of evidence-based practice in occupational health services in Sweden: a 3-year follow-up of attitudes, barriers and facilitators.

作者信息

Brämberg Elisabeth Björk, Nyman Teresia, Kwak Lydia, Alipour Akbar, Bergström Gunnar, Elinder Liselotte Schäfer, Hermansson Ulric, Jensen Irene

机构信息

Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, 171 77, Stockholm, Sweden.

Unit of Ergonomics, School of Technology and Health, KTH Royal Institute of Technology, Stockholm, Sweden.

出版信息

Int Arch Occup Environ Health. 2017 May;90(4):335-348. doi: 10.1007/s00420-017-1200-8. Epub 2017 Feb 15.

Abstract

PURPOSE

The Swedish government initiated an investigation of how to secure and develop the competence of the occupational health services. The primary aim of the present study was to investigate whether the development of evidence-based practice (EBP) in the Swedish occupational health services in relation to attitudes, knowledge and use improved during the first 3 years of the government's initiative.

METHODS

The study has a mixed methods design combining questionnaires and interviews with data collection at baseline and at 3-year follow-up.

RESULTS

The response rate was 66% at baseline and 63% at follow-up. The results show that practitioners' knowledge of EBP was moderate at baseline and improved at follow-up (p = 0.002; 95% CI 0.01; 0.21). Practitioners experienced lower levels of organizational and managerial support for EBP at follow-up (p < 0.001; 95% CI 0.18; 0.38). The results revealed that managers viewed responsibility for implementing EBP as a matter for individual practitioners rather than as an organizational issue.

CONCLUSIONS

Occupational health service managers and practitioners are generally positive to EBP. However, the findings emphasize the need to educate managers in how to support EBP at the organizational level by creating an infrastructure for EBP in the OHS.

摘要

目的

瑞典政府发起了一项关于如何保障和发展职业健康服务能力的调查。本研究的主要目的是调查在政府倡议的头3年里,瑞典职业健康服务中基于证据的实践(EBP)在态度、知识和应用方面的发展是否有所改善。

方法

本研究采用混合方法设计,将问卷调查和访谈与基线及3年随访时的数据收集相结合。

结果

基线时的回复率为66%,随访时为63%。结果显示,从业者对EBP的知识在基线时处于中等水平,随访时有所提高(p = 0.002;95%可信区间0.01;0.21)。从业者在随访时感受到对EBP的组织和管理支持水平较低(p < 0.001;95%可信区间0.18;0.38)。结果表明,管理者将实施EBP的责任视为个体从业者的事情,而非组织问题。

结论

职业健康服务管理者和从业者总体上对EBP持积极态度。然而,研究结果强调需要对管理者进行培训,使其了解如何通过在职业健康服务中创建EBP基础设施,在组织层面支持EBP。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cbcd/5387008/1464cffd5a3c/420_2017_1200_Fig1_HTML.jpg

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