Al Araimi Fannah Al Fannah
Integrated Management of Childhood Illness Expert, Ministry of Health, Muscat, Oman.
Oman Med J. 2017 May;32(3):221-226. doi: 10.5001/omj.2017.41.
Despite broad adoption and implementation of Integrated Management of Childhood Illness (IMCI) in more than 100 countries, childhood mortality and morbidity rates continue to prevail. This calls for further investigation to identify the factors that prevent actual application of IMCI-recommended clinical practices. This study tests a hypothetical structural model to investigate potential role of government and healthcare policymakers on improving implementation and application of IMCI-recommended practices in clinical setting.
The study was carried out at Sur and Ibra Nursing Institutes in Oman, in June 2016. We used six pre-tested and validated constructs for developing a hypothetical structural model. The constructs were used as underlying variables to examine the probable influence of government and policymakers on actual application of IMCI-recommended practices. Data were collected through structured questionnaires, which designed to measure healthcare professionals' perceptions. Each construct was pre-loaded with three sub-constructs. Cronbach's alpha (CA) was used to calculate the internal consistency and reliability.
Factor loadings for each item in the model were ≥ 0.700. CA values for all the studied constructs were > 0.600. The average variance extracted values for all the constructs were > 0.500.
The findings support the hypothetical structural model and highlights governments could play a significant role in ensuring that IMCI strategy is not only implemented, but also its recommended practices are applied in clinical setting.
尽管100多个国家广泛采用并实施了儿童疾病综合管理（IMCI），但儿童死亡率和发病率仍然居高不下。这就需要进一步调查，以确定阻碍实际应用IMCI推荐临床实践的因素。本研究测试了一个假设的结构模型，以调查政府和医疗保健政策制定者在改善IMCI推荐实践在临床环境中的实施和应用方面的潜在作用。
该研究于2016年6月在阿曼的苏尔和伊卜护理学院进行。我们使用了六个经过预测试和验证的结构来构建一个假设的结构模型。这些结构被用作潜在变量，以检验政府和政策制定者对IMCI推荐实践实际应用的可能影响。数据通过结构化问卷收集，该问卷旨在衡量医疗保健专业人员的看法。每个结构都预先加载了三个子结构。使用克朗巴哈系数（CA）来计算内部一致性和可靠性。
模型中每个项目的因子载荷≥0.700。所有研究结构的CA值>0.600。所有结构的平均方差提取值>0.500。
研究结果支持假设的结构模型，并强调政府在确保IMCI战略不仅得到实施，而且其推荐实践在临床环境中得到应用方面可以发挥重要作用。
