全科医生对预防保健质量改进反馈的看法和偏好：瑞士和法国的横断面研究。

General practitioners' views and preferences about quality improvement feedback in preventive care: a cross-sectional study in Switzerland and France.

机构信息

Primary Care Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland.

Department of General Practice, Faculty of Medicine, University of Nantes, Nantes, France.

出版信息

Implement Sci. 2017 Jul 26;12(1):95. doi: 10.1186/s13012-017-0623-7.

DOI:10.1186/s13012-017-0623-7

PMID:28747187

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5530524/

Abstract

BACKGROUND

Feedback is widely used as a strategy to improve the quality of care in primary care settings. As part of a study conducted to explore the quality of preventive care, we investigated general practitioners' (GPs) views on the usefulness of feedback and their preferences regarding how feedback is provided.

METHODS

This cross-sectional study was conducted in 2015 among randomly selected community-based GPs in two regions of Switzerland and France. GPs were asked to complete an anonymous questionnaire about how often they provided 12 measures of preventive care: blood pressure, weight and height measurements, screening for dyslipidemia, at-risk drinking (and advice to reduce for at-risk drinkers), smoking (and advice to stop for smokers), colon and prostate cancer, and influenza immunization for patients >65 years and at-risk patients. They were also asked to estimate the usefulness of a feedback regarding their preventive care practice, reason(s) for which a feedback could be useful, and finally, to state which type of feedback they would like to receive. Chi-square tests were used to compare frequencies. Multivariate logistic regression was used to identify factors associated with GPs considering feedback as useful.

RESULTS

Five hundred eighteen of 1100 GPs (47.1%) returned the questionnaire. They were predominantly men (62.5%) and most (40.1%) were aged between 55 and 64 years old. Overall, 44.3% stated that a feedback would be useful. Younger GPs and those carrying out more measures of preventive care were more likely to consider feedback useful. The two main reasons for being interested in feedback were to receive knowledge about the study results and to modify or improve practice. The two preferred feedback interventions were a brief report and a report with specific information regarding prevention best practice, whereas less than 1% would like to discuss the results face-to-face with the study investigators.

CONCLUSIONS

These findings suggest that GPs have preferences regarding the types of feedback they would like to receive. Because the implementation of guidelines is highly related to the acceptance of feedback, we strongly encourage decision makers to take GPs' preferences into account when developing strategies to implement guidelines, in order to improve the quality of primary care.

摘要

背景

反馈作为提高初级保健服务质量的策略已被广泛应用。作为探索预防性护理质量的研究的一部分，我们调查了全科医生对反馈有用性的看法以及他们对反馈提供方式的偏好。

方法

这项横断面研究于 2015 年在瑞士和法国的两个地区随机选择的社区全科医生中进行。全科医生被要求完成一份关于他们提供 12 项预防保健措施（血压、体重和身高测量、血脂异常筛查、高危饮酒（高危饮酒者的建议减少饮酒）、吸烟（吸烟者的建议戒烟）、结肠癌和前列腺癌、流感疫苗接种（>65 岁患者和高危患者）的频率的匿名问卷。他们还被要求估计他们的预防保健实践的反馈的有用性、反馈可能有用的原因，以及他们希望收到哪种类型的反馈。卡方检验用于比较频率。多变量逻辑回归用于确定与全科医生认为反馈有用相关的因素。

结果

1100 名全科医生中有 518 名（47.1%）返回了问卷。他们主要是男性（62.5%），大多数（40.1%）年龄在 55 至 64 岁之间。总体而言，44.3%的人表示反馈将是有用的。年轻的全科医生和进行更多预防措施的医生更有可能认为反馈有用。对反馈感兴趣的两个主要原因是了解研究结果和修改或改进实践。两种首选的反馈干预措施是简短报告和具有预防最佳实践具体信息的报告，而不到 1%的人希望与研究人员面对面讨论结果。