开发一项培训计划，以支持医疗保健专业人员实施慢性阻塞性肺疾病自我管理的“空间”计划。
Development of a training program to support health care professionals to deliver the SPACE for COPD self-management program.
作者信息
Blackmore Claire, Johnson-Warrington Vicki L, Williams Johanna Ea, Apps Lindsay D, Young Hannah Ml, Bourne Claire LA, Singh Sally J
机构信息
Kettering General Hospital National Health Service (NHS) Trust, Kettering, Northamptonshire.
Centre for Exercise and Rehabilitation Science, Leicester Respiratory Biomedical Research Unit, University Hospitals of Leicester NHS Trust, Leicester, UK.
出版信息
Int J Chron Obstruct Pulmon Dis. 2017 Jun 7;12:1669-1681. doi: 10.2147/COPD.S127504. eCollection 2017.
BACKGROUND
With the growing burden of COPD and associated morbidity and mortality, a need for self-management has been identified. The Self-management Programme of Activity, Coping and Education for Chronic Obstructive Pulmonary Disease (SPACE for COPD) manual was developed to support self-management in COPD patients. Currently, there is no literature available regarding health care professionals' training needs when supporting patients with COPD on self-management.
AIM
This study sought to identify these needs to inform, design and develop a training program for health care professionals being trained to deliver a self-management program in COPD.
METHODS
Fourteen health care professionals from both primary and secondary care COPD services participated in face-to-face semistructured interviews. Thematic analysis was used to produce a framework and identify training needs and views on delivery of the SPACE for COPD self-management program. Components of training were web-based knowledge training, with pre-and posttraining knowledge questionnaires, and a 1-day program to introduce the self-management manual. Feedback was given after training to guide the development of the training program.
RESULTS
Health care professionals were able to identify areas where they required increased knowledge to support patients. This was overwhelming in aspects of COPD seen to be outside of their current clinical role. Skills in goal setting and behavioral change were not elicited as a training need, suggesting a lack of understanding of components of supporting self-management. An increase in knowledge of COPD was demonstrated following the training program.
CONCLUSION
Both knowledge and skill gaps existed in those who would deliver self-management. Analysis of this has enabled a training program to be designed to address these gaps and enable health care professionals to support patients in self-management.
背景
随着慢性阻塞性肺疾病（COPD）负担的不断加重以及相关发病率和死亡率的上升，人们已经认识到自我管理的必要性。慢性阻塞性肺疾病自我管理活动、应对与教育计划（SPACE for COPD）手册的制定是为了支持COPD患者的自我管理。目前，关于医护人员在支持COPD患者进行自我管理时的培训需求，尚无相关文献。
目的
本研究旨在确定这些需求，以为培训医护人员提供COPD自我管理计划的培训项目提供信息、进行设计和开发。
方法
来自初级和二级护理COPD服务机构的14名医护人员参与了面对面的半结构化访谈。采用主题分析法生成一个框架，并确定培训需求以及对实施SPACE for COPD自我管理计划的看法。培训内容包括基于网络的知识培训，培训前后进行知识问卷调查，以及为期1天的介绍自我管理手册的项目。培训后提供反馈以指导培训项目的开发。
结果
医护人员能够确定他们需要增加知识以支持患者的领域。在被认为超出其当前临床角色的COPD方面，这一需求极为强烈。目标设定和行为改变方面的技能未被列为培训需求，这表明对支持自我管理的组成部分缺乏理解。培训项目实施后，医护人员对COPD的知识有所增加。
结论
在提供自我管理的人员中存在知识和技能差距。对此进行分析后，得以设计一个培训项目来弥补这些差距，使医护人员能够支持患者进行自我管理。
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