Blackstone Sarah, Iwelunmor Juliet, Plange-Rhule Jacob, Gyamfi Joyce, Quakyi Nana Kofi, Ntim Micheal, Ogedegbe Gbenga
Doctoral Candidate, Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, IL.
Assistant Professor, Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, IL.
Worldviews Evid Based Nurs. 2017 Oct;14(5):350-357. doi: 10.1111/wvn.12230. Epub 2017 Apr 27.
The use of task-shifting is an increasingly widespread delivery approach for health interventions targeting prevention, treatment, and control of hypertension in adults living in sub-Saharan Africa (SSA). Addressing a gap in the literature, this research examined the sustainability of an ongoing task-shifting strategy for hypertension (TASSH) from the perspectives of community health nurses (CHNs) implementing the program.
We used concept-mapping, a mixed-methods participatory approach to understand CHNs' perceptions of barriers and enablers to sustaining a task-shifting program. Participants responded to focal prompts, eliciting statements regarding perceived barriers and enablers to sustaining TASSH, and then rated these ideas based on importance to the research questions and feasibility to address. Twenty-eight community health nurses (21 women, 7 men) from the Ashanti region of Ghana completed the concept-mapping process.
Factors influencing sustainability were grouped into five categories: Limited Drug Supply, Financial Support, Provision of Primary Health Care, Personnel Training, and Patient-Provider Communication. The limited supply of antihypertensive medication was considered by CHNs as the most important item to address, while providing training for intervention personnel was considered most feasible to address.
This study's findings highlight the importance of examining nurses' perceptions of factors likely to influence the sustainability of evidence-based, task-shifting interventions. Nurses' perceptions can guide the widespread uptake and dissemination of these interventions in resource-limited settings.
任务转移作为一种卫生干预措施的实施方式，在撒哈拉以南非洲（SSA）针对成年人高血压的预防、治疗和控制方面正日益广泛应用。为填补文献空白，本研究从实施该项目的社区卫生护士（CHN）的角度，考察了正在进行的高血压任务转移策略（TASSH）的可持续性。
我们采用概念映射法，这是一种混合方法参与式途径，以了解社区卫生护士对维持任务转移项目的障碍和促进因素的看法。参与者回应焦点提示，引出关于维持TASSH的感知障碍和促进因素的陈述，然后根据对研究问题的重要性和解决的可行性对这些观点进行评分。来自加纳阿散蒂地区的28名社区卫生护士（21名女性，7名男性）完成了概念映射过程。
影响可持续性的因素分为五类：药品供应有限、财政支持、初级卫生保健提供、人员培训以及医患沟通。社区卫生护士认为抗高血压药物供应有限是最需要解决的问题，而对干预人员进行培训被认为是最可行的解决办法。
本研究结果凸显了考察护士对可能影响循证任务转移干预措施可持续性的因素的看法的重要性。护士的看法可指导这些干预措施在资源有限环境中的广泛采用和推广。
