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用于实施痴呆风险降低的精细化概念模型:纳入澳大利亚全科医学观点。

Refined conceptual model for implementing dementia risk reduction: incorporating perspectives from Australian general practice.

机构信息

Department of General Practice, Melbourne Medical School, The University of Melbourne, Vic. 3010, Australia; and Corresponding author. Email:

Department of General Practice, Melbourne Medical School, The University of Melbourne, Vic. 3010, Australia.

出版信息

Aust J Prim Health. 2020 Jun;26(3):247-255. doi: 10.1071/PY19249.

Abstract

Dementia is now a global health priority. With no known cure, the best way to reduce the number of people who will be living with dementia is by promoting dementia risk reduction (DRR). However, despite evidence-based guidelines, DRR is not yet routinely promoted in Australian general practice. Previously, we proposed a preliminary conceptual model for implementing DRR in primary care based on our scoping review of practitioners' views. The present study aimed to refine this model for the Australian context by incorporating the current perspectives of Australian general practitioners (GPs) and general practice nurses (GPNs) about DRR. Interviews with 17 GPs and GPNs were analysed using the framework method, underpinned by the Consolidated Framework for Implementation Research (CFIR). We identified 12 barriers to promoting DRR in Australian general practice, along with five facilitators. Using the CFIR-Expert Recommendations for Implementing Change (ERIC) Matching Tool to select prioritised implementation strategies from the ERIC project, the findings were incorporated into a refined conceptual model. The refined model points to an implementation intervention that uses educational materials and meetings to reach consensus with GPs and GPNs on the importance of promoting DRR and an appropriate approach. Champion GPs and GPNs should be prepared to drive the agreed implementation forward, and general practices should share successes and lessons learned. This model is a crucial step in bridging the gap between DRR guidelines and routine practice.

摘要

痴呆症现在是全球卫生重点。由于目前尚无治愈方法,减少痴呆症患者人数的最佳方法是促进痴呆症风险降低(DRR)。然而,尽管有循证指南,但 DRR 尚未在澳大利亚全科医学中常规推广。此前,我们根据对从业者观点的系统评价,提出了一个在初级保健中实施 DRR 的初步概念模型。本研究旨在通过纳入澳大利亚全科医生(GP)和全科护士(GPN)目前对 DRR 的看法,为澳大利亚背景下对该模型进行完善。对 17 名全科医生和全科护士的访谈采用框架方法进行分析,该方法以实施研究综合框架(CFIR)为基础。我们确定了在澳大利亚全科医学中促进 DRR 的 12 个障碍,以及 5 个促进因素。使用 CFIR-实施变革专家建议(ERIC)匹配工具从 ERIC 项目中选择优先实施策略,将研究结果纳入完善的概念模型。完善后的模型指出,实施干预措施可以使用教育材料和会议,与全科医生和全科护士就促进 DRR 的重要性和适当方法达成共识。拥护者全科医生和全科护士应准备好推动商定的实施工作,并且全科医生应分享成功经验和教训。该模型是弥合 DRR 指南与常规实践之间差距的重要一步。

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