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低收入和中等收入国家儿科重症监护临床研究人员面临的挑战与优先事项

Challenges and Priorities for Pediatric Critical Care Clinician-Researchers in Low- and Middle-Income Countries.

作者信息

von Saint André-von Arnim Amelie O, Attebery Jonah, Kortz Teresa Bleakly, Kissoon Niranjan, Molyneux Elizabeth M, Musa Ndidiamaka L, Nielsen Katie R, Fink Ericka L

机构信息

Department of Pediatrics, Division of Pediatric Critical Care, Seattle Children's Hospital, University of Washington, Seattle, WA, United States.

Department of Global Health, University of Washington, Seattle, WA, United States.

出版信息

Front Pediatr. 2017 Dec 22;5:277. doi: 10.3389/fped.2017.00277. eCollection 2017.

Abstract

INTRODUCTION

There is need for more data on critical care outcomes and interventions from low- and middle-income countries (LMIC). Global research collaborations could help improve health-care delivery for critically ill children in LMIC where child mortality rates remain high.

MATERIALS AND METHODS

To inform the role of collaborative research in health-care delivery for critically ill children in LMIC, an anonymous online survey of pediatric critical care (PCC) physicians from LMIC was conducted to assess priorities, major challenges, and potential solutions to PCC research. A convenience sample of 56 clinician-researchers taking care of critically ill children in LMIC was targeted. In addition, the survey was made available on a Latin American PCC website. Descriptive statistics were used for data analysis.

RESULTS

The majority of the 47 survey respondents worked at urban, public teaching hospitals in LMIC. Respondents stated their primary PCC research motivations were to improve clinical care and establish guidelines to standardize care. Top challenges to conducting research were lack of funding, high clinical workload, and limited research support staff. Respondent-proposed solutions to these challenges included increasing research funding options for LMIC, better access to mentors from high-income countries, research training and networks, and higher quality medical record documentation.

CONCLUSION

LMIC clinician-researchers must be better empowered and resourced to lead and influence the local and global health research agenda for critically ill children. Increased funding options, access to training and mentorship in research methodology, and improved data collection systems for LMIC PCC researchers were recognized as key needs for success.

摘要

引言

低收入和中等收入国家(LMIC)需要更多关于重症监护结果和干预措施的数据。全球研究合作有助于改善LMIC中重症儿童的医疗服务,因为这些地区的儿童死亡率仍然很高。

材料与方法

为了了解合作研究在LMIC重症儿童医疗服务中的作用,对来自LMIC的儿科重症监护(PCC)医生进行了一项匿名在线调查,以评估PCC研究的重点、主要挑战和潜在解决方案。目标是抽取56名在LMIC照顾重症儿童的临床研究人员作为便利样本。此外,该调查在一个拉丁美洲PCC网站上发布。采用描述性统计进行数据分析。

结果

47名调查受访者中的大多数在LMIC的城市公立教学医院工作。受访者表示,他们进行PCC研究的主要动机是改善临床护理并制定护理标准化指南。开展研究的主要挑战包括资金短缺、临床工作量大以及研究支持人员有限。受访者针对这些挑战提出的解决方案包括增加LMIC的研究资金选择、更好地获得来自高收入国家的导师指导、研究培训和网络以及更高质量的病历记录。

结论

必须更好地增强LMIC临床研究人员的能力并为其提供资源,以引领和影响针对重症儿童的本地和全球健康研究议程。增加资金选择、获得研究方法方面的培训和指导以及改善LMIC PCC研究人员的数据收集系统被认为是取得成功的关键需求。

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