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研究在农村卫生工作场所结构中的地位:对农村卫生组织战略和运营文件的内容分析。

The place of research in the rural health workplace structure: a content analysis of a rural health organisation's strategic and operational documents.

机构信息

The University of Sydney, Sydney School of Public Health, Faculty of Medicine and Health, Sydney, NSW, 2006, Australia

Clinical Governance, Murrumbidgee Local Health District, Wagga Wagga, NSW 2650, Australia

出版信息

Rural Remote Health. 2020 Apr;20(2):5493. doi: 10.22605/RRH5493. Epub 2020 Apr 17.

Abstract

INTRODUCTION

Research training is conducted within rural health organisations without a clear understanding of the role of research within the structure of the organisation itself, potentially limiting the effectiveness of that training. This study sought to identify the role of research within the organisational structure of a large rural health organisation in Australia. Specifically, the study sought the answer to the following questions: Is research identified within the strategic documents of the organisation? If so at what level of the organisation is responsibility for research attributed? Is research identified within the position descriptions of staff? If so, at what level of the organisation are staff expected to conduct research? Is there evidence of research activity elsewhere within the organisational structure?

METHODS

This qualitative study used a critical realist approach and content analysis to identify and contextualise the terms 'research' and 'evaluation' within publicly available and internal documents from a large rural health organisation in New South Wales, Australia. Secondary thematic analysis identified organisational factors influencing research activity. Data were sourced from strategic, operational and other documents from the 2015 calendar year, with key documents extracted from 1654 external and internal websites, 159 position descriptions and approvals for research projects active in 2015 (n=53).

RESULTS

Only a third of research conducted in the organisation was locally instigated or involved local staff as researchers. Matching between positional responsibility for research and research activity was limited. Research was a strategic goal for the organisation; however, this was not well represented in operational documents. A lack of research in operational documents devolves responsibility for research to individuals. Individuals with greater levels of individual agency were more likely to be engaged in research. A low critical mass of local researchers means that collaboration, both internal and external, is essential to strengthen research capacity.

CONCLUSION

Health services can create conditions for local health research in a rural environment by addressing structural barriers such as a lack of operational planning for research. Identifying research-active individuals as champions to build internal research collaboration is an important strategy, as is partnering with external organisations for necessary expertise.

摘要

简介

在农村卫生组织中进行研究培训,但对研究在组织结构中的作用缺乏清晰的认识,这可能会限制培训的效果。本研究旨在确定澳大利亚一家大型农村卫生组织的组织结构中的研究作用。具体来说,本研究试图回答以下问题:研究在组织的战略文件中是否得到确定?如果是,研究责任归属组织的哪个级别?研究在员工的职位描述中是否得到确定?如果是,员工在组织的哪个级别被期望进行研究?组织结构的其他部分是否有研究活动的证据?

方法

本定性研究采用批判现实主义方法和内容分析,在澳大利亚新南威尔士州一家大型农村卫生组织的公开和内部文件中确定和背景化“研究”和“评估”的术语。二次主题分析确定了影响研究活动的组织因素。数据来自 2015 年日历年度的战略、运营和其他文件,从 1654 个外部和内部网站、159 个职位描述和 2015 年正在进行的研究项目批准中提取关键文件(n=53)。

结果

只有三分之一的组织内进行的研究是由当地发起或涉及当地员工作为研究人员的。研究责任与研究活动之间的匹配有限。研究是组织的战略目标,但在运营文件中没有很好地体现。运营文件中缺乏研究,将研究责任下放到个人身上。具有较高个人代理水平的个人更有可能参与研究。当地研究人员的数量较少意味着内部和外部的合作对于加强研究能力至关重要。

结论

卫生服务部门可以通过解决研究运营规划不足等结构性障碍,为农村环境中的本地卫生研究创造条件。确定研究活跃的个人作为建立内部研究合作的拥护者是一项重要战略,与外部组织合作以获取必要的专业知识也是如此。

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