Pagnamenta Fania, Lhussier Monique
Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
Northumbria University, Newcastle upon Tyne, UK.
J Eval Clin Pract. 2018 Oct;24(5):988-994. doi: 10.1111/jep.12989. Epub 2018 Jul 20.
RATIONALE, AIMS, AND OBJECTIVES: The aim of this paper is to (1) summarize the challenges with developing evidence for dressing selection in wound care, (2) discuss the limiting influence that the Evidence-Based Practice movement has had in this field, and (3) discuss the opportunities offered by Dewey's theory of experimentalism as a pragmatic solution to develop a structured body of evidence.
Whilst the number of dressings available on the market continue to proliferate, limited progress has taken place to develop a methodology for dressing evaluation that is relevant to clinical practice. It is proposed that experimentalism can be operationalized with a mixed-methods approach that may include the following: (1) medical histories and patient's stories; (2) participant observation and informal interviews; (3) a comparative study between a new dressing and standard care; (4) a patient's satisfaction survey; (5) a staff survey; (6) a cost examination; (7) an evaluation of the packaging and procurement route; and finally (8) a clinical meeting to triangulate the data and reach a consensus.
Experimentalism offers a framework for the construction of evidence used for dressing selection. Central to this concept is the integration of experience to the data collected. The context of the evaluation has equal weight to the data thus collected.
理论依据、目的和目标:本文旨在(1)总结伤口护理中敷料选择证据发展面临的挑战,(2)探讨循证实践运动在该领域产生的限制影响,以及(3)讨论杜威的实验主义理论作为一种实用解决方案为构建结构化证据体系带来的机遇。
虽然市场上可用的敷料数量持续增加,但在开发与临床实践相关的敷料评估方法方面进展有限。建议可以通过混合方法来实施实验主义,该方法可能包括以下内容:(1)病史和患者故事;(2)参与观察和非正式访谈;(3)新敷料与标准护理的比较研究;(4)患者满意度调查;(5)员工调查;(6)成本审查;(7)包装和采购途径评估;最后(8)召开临床会议以对数据进行三角测量并达成共识。
实验主义为构建用于敷料选择的证据提供了一个框架。这一概念的核心是将经验与收集到的数据相结合。评估的背景与如此收集的数据具有同等重要性。