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院外心脏骤停中利益相关者对随机分组及资金决策的优先级和观点差异:一项探索性研究。

Variations in stakeholders' priorities and views on randomisation and funding decisions in out-of-hospital cardiac arrest: An exploratory study.

作者信息

von Vopelius-Feldt Johannes, Brandling Janet, Benger Jonathan

机构信息

Academic Department of Emergency Care University Hospitals Bristol NHS Foundation Trust Bristol UK.

Emergency and Critical Care Research, Faculty of Health & Applied Sciences University of the West of England Bristol UK.

出版信息

Health Sci Rep. 2018 Jul 25;1(9):e78. doi: 10.1002/hsr2.78. eCollection 2018 Sep.

Abstract

BACKGROUND AND AIMS

Prehospital critical care for out-of-hospital cardiac arrest (OHCA) is a complex and largely unproven intervention. During research to examine this intervention, we noted significant differences in stakeholders' views about research, randomisation, and the funding of prehospital critical care for OHCA. We aimed to answer the following questions: What are stakeholders' priorities for prehospital research? What are stakeholders' views on randomisation of prehospital critical care? How do stakeholders consider allocation of resources in prehospital care?

METHODS

We undertook an explanatory qualitative framework analysis of interviews and focus group with 5 key stakeholder groups: patients and public, air ambulance charities, ambulance service commissioners, prehospital researchers, and prehospital critical care providers.

RESULTS

We undertook 3 focus group discussions with a total of 23 participants and 8 interviews with a total of 9 participants. Despite sharing a common appreciation of the concepts of scientific enquiry, fairness, and beneficence, the 5 relevant stakeholder groups displayed divergent views of research and funding strategies regarding the intervention of prehospital critical care for the condition of OHCA. The reasons for this divergence could largely be explained through the different personal experiences and situational contexts of each stakeholder group. Many aspects of the strategies suggested by the stakeholder groups only partially aligned with principles of traditional evidence-based medicine, but were held with strong conviction.

DISCUSSION

Analysis of the views of 5 stakeholder groups regarding research and the funding of prehospital critical care for OHCA revealed shared values but a variety of different strategies to achieve these. This knowledge can help researchers in similar fields in the planning and presentation of their research, to maximise impact on decision making.

摘要

背景与目的

院外心脏骤停(OHCA)的院前重症护理是一项复杂且在很大程度上未经证实的干预措施。在研究这项干预措施的过程中,我们注意到利益相关者在关于研究、随机分组以及OHCA院前重症护理资金方面的观点存在显著差异。我们旨在回答以下问题:利益相关者对院前研究的优先事项是什么?利益相关者对院前重症护理随机分组的看法是什么?利益相关者如何看待院前护理中的资源分配?

方法

我们对5个关键利益相关者群体进行了访谈和焦点小组讨论,并进行了解释性定性框架分析,这5个群体分别是:患者及公众、空中救护慈善机构、救护服务专员、院前研究人员以及院前重症护理提供者。

结果

我们进行了3次焦点小组讨论,共有23名参与者,以及8次访谈,共有9名参与者。尽管对科学探究、公平和仁爱概念有着共同的理解,但这5个相关利益相关者群体在OHCA院前重症护理干预的研究和资金策略上表现出不同的观点。这种差异的原因很大程度上可以通过每个利益相关者群体不同的个人经历和情境来解释。利益相关者群体提出的策略的许多方面仅部分符合传统循证医学原则,但却被坚定地持有。

讨论

对5个利益相关者群体关于OHCA院前重症护理研究和资金的观点分析揭示了共同的价值观,但实现这些价值观有多种不同的策略。这些知识可以帮助类似领域的研究人员在规划和展示他们的研究时,最大限度地影响决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/714e/6266350/71f72c81cc62/HSR2-1-e78-g001.jpg

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