University of Rwanda, College of Medicine and Health Sciences, Kigali, Rwanda.
University of Cape Town, Cape Town, South Africa.
PLoS One. 2020 Feb 7;15(2):e0226247. doi: 10.1371/journal.pone.0226247. eCollection 2020.
Appropriate collaboration between health professionals (HP) can reduce medical errors, enhance the spread of critical information, and assist in interpretation of health information resulting in improved patient care. The International Classification of Functioning, Disability and Health (ICF) may provide a useful conceptual framework to facilitate better interprofessional practice.
To determine whether a training programme based on the ICF framework resulted in improved interprofessional behaviour among HPs in Rwanda.
A cluster randomised control trial was used. Four district hospitals were randomly allocated to receive either a day's training in interprofessional practice based on the ICF framework (experimental) or a short talk and a booklet on the topic (control). A total of 203 participants included medical doctors, nurses, and other HPs took part in this study. Simple random sampling was used to select the hospital records of 200 patients discharged from relevant wards at both the experimental and control hospitals at baseline and at two, four and six months after training (800 patients' records from each group). A self-designed checklist has undergone some validation and was based on the ICF conceptual model was used to audit the quality of information included in the patients' records. Ethical approval was obtained from the relevant authorities.
The demographic and medical profile of the patients in the two sets was equivalent. An ANOVA and post-hoc Tukey test indicated the mean number of items correctly filled in was not significant at baseline (p = 0.424) but the difference was significant (p < .001) for the post-intervention scores at two, four and six months. The control group scores did not improve over time. The improved behavior was still evident at six months although it had begun to decay.
Behaviour change as evidenced by more comprehensive recording of patient management can result from a well-structured training programme. The ICF appeared to provide a common language and facilitate HPs interaction and patient management plans.
The ICF provided an effective conceptual framework to structure the content of the training and the audit tool. It is recommended that the framework be used to facilitate interprofessional education and practice in Rwanda and that the training approach may be applicable to other health care contexts.
健康专业人员（HP）之间的适当合作可以减少医疗错误，增强关键信息的传播，并有助于解释健康信息，从而改善患者护理。《国际功能、残疾和健康分类》（ICF）可以为促进更好的跨专业实践提供有用的概念框架。
确定基于 ICF 框架的培训计划是否会提高卢旺达卫生专业人员的跨专业行为。
采用集群随机对照试验。将 4 家地区医院随机分配接受为期一天的 ICF 框架跨专业实践培训（实验组）或简短演讲和小册子（对照组）。共有 203 名包括医生、护士和其他卫生专业人员在内的参与者参加了这项研究。简单随机抽样用于选择实验组和对照组相关病房出院患者的 200 份病历，基线时和培训后 2、4 和 6 个月（每组 800 份病历）。一个自我设计的检查表已经过一些验证，并基于 ICF 概念模型，用于审核患者记录中包含的信息质量。已从相关当局获得伦理批准。
两组患者的人口统计学和医疗概况相当。方差分析和事后 Tukey 检验表明，基线时正确填写的项目平均值没有显著差异（p = 0.424），但干预后 2、4 和 6 个月的差异非常显著（p <.001）。对照组的分数随着时间的推移没有提高。尽管行为改善开始减弱，但在 6 个月时仍然明显。
通过更全面地记录患者管理，可以实现行为的改变，从而证明培训计划有效。ICF 似乎提供了一种通用语言，促进了 HP 之间的互动和患者管理计划。
ICF 为培训内容和审核工具提供了有效的概念框架。建议在卢旺达使用该框架来促进跨专业教育和实践，并认为该培训方法可能适用于其他医疗保健环境。
