NICM Health Research Institute, Western Sydney University, Penrith, Australia.
School of Medicine, Western Sydney University, Penrith, Australia.
J Altern Complement Med. 2020 Apr;26(4):300-315. doi: 10.1089/acm.2019.0321. Epub 2020 Feb 21.
To engage with local primary care stakeholders to inform the model of care for a proposed academic integrative health care center incorporating evidence-informed traditional, complementary, and integrative medicine (TCIM) in Sydney, Australia. In-depth semistructured interviews, informed by community-based participatory research principles, were conducted to explore primary care stakeholder preferences and service requirements regarding the proposed Western Sydney Integrative Health (WSIH) center in their local district. Telephone and face-to-face interviews at primary care clinics in Sydney. Thirteen participants took part in the study: eight general practitioners (GPs) and five primary care practice managers (PMs). GPs were recruited through local GP newsletters, closed GP Facebook groups, and snowballing. PMs were recruited through a national PM newsletter. The semistructured interviews were audiorecorded and transcribed verbatim before conducting a thematic analysis. Three main themes emerged: (1) the rationale for "why" the WSIH center should be established, (2) "what" was most important to provide, and (3) "how" the center could achieve these goals. Participants were willing to refer to the service, acknowledging the demand for TCIM, current gaps in chronic disease care, and negligible Government funding for TCIM. They endorsed a model of care that minimizes out-of-pocket costs for the underserved, incorporates medical oversight, integrates evidence-informed TCIM with conventional health care, builds trust through interprofessional communication and education, and provides sound clinical governance with a strong focus on credentialing and risk management. It was proposed that safety and quality standards are best met by a GP-led approach and evidence-based practice. Our findings demonstrate that participants acknowledged the need for a model of care that fits into the local landscape through integrating conventional health care with TCIM in a team-based environment, with medical/GP oversight to ensure sound clinical governance. Findings will be used with input from other stakeholder groups to refine the WSIH model of care.
与当地初级保健利益相关者合作，为拟在澳大利亚悉尼建立的学术综合医疗中心提供信息，该中心将纳入循证传统、补充和综合医学（TCIM）。采用基于社区的参与式研究原则进行深入的半结构化访谈，以探讨初级保健利益相关者对拟议的西悉尼综合健康（WSIH）中心在当地地区的偏好和服务需求。在悉尼的初级保健诊所进行电话和面对面访谈。共有 13 名参与者参加了这项研究：8 名全科医生（GP）和 5 名初级保健诊所经理（PM）。通过当地 GP 通讯、封闭的 GP Facebook 群组和滚雪球的方式招募 GP。通过全国 PM 通讯招募 PM。对半结构化访谈进行录音并逐字转录，然后进行主题分析。出现了三个主要主题：（1）建立 WSIH 中心的“理由”；（2）“什么”是最重要的提供内容；（3）中心如何实现这些目标。参与者愿意转介该服务，承认对 TCIM 的需求、慢性病护理方面的当前差距以及政府对 TCIM 的资助微不足道。他们支持一种医疗模式，为服务不足的人群最大限度地降低自付费用，纳入医疗监督，将循证 TCIM 与常规医疗相结合，通过跨专业沟通和教育建立信任，并提供注重认证和风险管理的健全临床治理。有人建议，通过以全科医生为主导的方法和循证实践，最好满足安全性和质量标准。我们的研究结果表明，参与者承认需要一种医疗模式，通过在团队环境中整合常规医疗和 TCIM，同时由医疗/GP 监督来确保健全的临床治理，以适应当地环境。将结合其他利益相关者群体的意见来完善 WSIH 的医疗模式。
