Roberts Shelley, Marshall Andrea, Chaboyer Wendy
National Centre of Research Excellence in Nursing, Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Gold Coast, QLD, 4222, Australia.
Gold Coast Hospital and Health Service and School of Nursing and Midwifery, Griffith University, Gold Coast Campus, Gold Coast, QLD, 4222, Australia.
BMC Med Inform Decis Mak. 2017 Jul 11;17(1):105. doi: 10.1186/s12911-017-0495-4.
Advancements in technology are enabling patients to participate in their health care through self-monitoring and self-management of diet, exercise and chronic disease. Technologies allowing patients to participate in hospital care are still emerging but show promise. Our team is developing a program by which hospitalised patients can participate in their nutrition care. This study explores hospital staffs' perceptions of using this technology to engage patients in their care.
This qualitative study involved semi-structured interviews with hospital staff providing routine nutrition care to patients (i.e. dietitians, nutrition assistants, nurses, doctors and foodservice staff) from five wards at a tertiary metropolitan teaching hospital in Australia. The hospital currently uses an electronic foodservice system (EFS) for patient meal ordering, accessed through personal screens at the bedside. Participants were shown the EFS program on an iPad and asked about their perceptions of the program, with questions from a semi-structured interview guide. Staff were interviewed individually or in small focus groups. Interviews lasted 15-30 min and were audio recorded and later transcribed. Data were analysed using thematic analysis.
Nineteen staff participated in interviews. Overall, they expressed positive views of the EFS program and wanted it to be implemented in practice. Their responses formed three themes, each with a number of subthemes: 1) Enacting patient participation in practice; 2) Optimising nutrition care; and 3) Considerations for implementing an EFS program in practice. Staff thought the program would improve various aspects of nutrition care and enable patient participation in care. Whilst they raised some concerns, they focused on overcoming barriers and facilitating implementation if the program were to be adopted into practice.
Staff found an EFS program designed to engage patients in their nutrition care acceptable, as they saw benefits to using it for both patients and staff. Staff recognised characteristics of the program itself, as well as allocation of roles and responsibilities in operationalising it, were pivotal for successful implementation in practice. Their perspectives will inform program and intervention design, and implementation and evaluation strategies.
技术进步使患者能够通过自我监测以及饮食、运动和慢性病的自我管理参与自身医疗保健。让患者参与医院护理的技术仍在不断涌现，但前景广阔。我们的团队正在开发一个项目，使住院患者能够参与自身的营养护理。本研究探讨医院工作人员对使用该技术让患者参与护理的看法。
这项定性研究包括对澳大利亚一家大都市三级教学医院五个病房中为患者提供常规营养护理的医院工作人员（即营养师、营养助理、护士、医生和餐饮服务人员）进行半结构化访谈。该医院目前使用电子餐饮服务系统（EFS）进行患者订餐，可通过床边的个人屏幕访问。研究人员在iPad上向参与者展示了EFS程序，并根据半结构化访谈指南中的问题询问他们对该程序的看法。工作人员单独或在小型焦点小组中接受访谈。访谈持续15 - 30分钟，进行了录音并随后转录。数据采用主题分析法进行分析。
19名工作人员参与了访谈。总体而言，他们对EFS程序表达了积极看法，并希望将其应用于实际。他们的回答形成了三个主题，每个主题都有若干子主题：1）在实践中实现患者参与；2）优化营养护理；3）在实践中实施EFS程序的考虑因素。工作人员认为该程序将改善营养护理的各个方面，并使患者能够参与护理。虽然他们提出了一些担忧，但如果该程序要付诸实践，他们专注于克服障碍并促进实施。
工作人员认为旨在让患者参与营养护理的EFS程序是可以接受的，因为他们认为该程序对患者和工作人员都有益处。工作人员认识到该程序本身的特点以及在实施过程中的角色和责任分配对于在实践中成功实施至关重要。他们的观点将为项目和干预措施的设计以及实施和评估策略提供参考。
