促进和阻碍标准化结局测量在唇腭裂儿童中的应用。
Facilitators and Barriers to Implementing Standardized Outcome Measurement for Children With Cleft Lip and Palate.
机构信息
Department of Clinical Research, Phoenix Children's Hospital, AZ, USA.
Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH, USA.
出版信息
Cleft Palate Craniofac J. 2021 Jan;58(1):7-18. doi: 10.1177/1055665620940187. Epub 2020 Jul 14.
OBJECTIVE
Identify facilitators and barriers to implementing standardized outcome measurement in cleft care.
DESIGN
Cross-sectional, qualitative study.
SETTING/PARTICIPANTS: Participants included 24 providers and staff from a large, multidisciplinary cleft team in the southwest United States, 5 caregivers of children with cleft palate (with or without cleft lip) treated by this team, and 3 experts involved in implementing a cleft-specific standardized outcome measurement in the United Kingdom.
INTERVENTIONS
Semistructured, qualitative interviews were conducted exploring perceived facilitators and barriers to implementing standardized outcome measurement in cleft care. Interviews were audio-recorded, transcribed, and analyzed for content. The Consolidated Framework for Implementation Research was used to guide the interviews and analysis. The analysis focused on the characteristics of standardized outcome measurement that directly influence its adoption.
RESULTS
Participants identified both facilitators and barriers to implementing standardized outcome measurement. Facilitators included the strength and quality of evidence supporting improvements in cleft care delivery following implementation of standardized outcome measurement and the relative advantage of standardized outcome measurement over continuing the status quo. Barriers included the difficulty adapting standardized outcome measurement to meet local context and patient-specific needs and the complexity of implementing standardized outcome measurement.
CONCLUSIONS
Providers, staff, and caregivers involved in cleft care perceive multiple benefits from standardized outcome measurement, while also recognizing substantial barriers to its implementation. Results from this study can be used to guide development of an implementation strategy for standardized outcome measurement that builds upon perceived strengths of the intervention and reduces perceived barriers.
目的
确定在唇腭裂护理中实施标准化结局测量的促进因素和障碍。
设计
横断面、定性研究。
设置/参与者：参与者包括美国西南部一个大型多学科唇腭裂团队的 24 名提供者和工作人员、5 名接受该团队治疗的腭裂（伴或不伴唇裂）患儿的照顾者，以及 3 名参与在英国实施特定于唇腭裂的标准化结局测量的专家。
干预措施
进行半结构化的定性访谈，探讨在唇腭裂护理中实施标准化结局测量的感知促进因素和障碍。访谈进行了录音、转录，并进行了内容分析。采用实施研究综合框架来指导访谈和分析。分析重点是直接影响其采用的标准化结局测量的特征。
结果
参与者确定了在实施标准化结局测量方面的促进因素和障碍。促进因素包括在实施标准化结局测量后改善唇腭裂护理提供的证据的强度和质量，以及标准化结局测量相对于维持现状的相对优势。障碍包括难以使标准化结局测量适应当地情况和患者特定需求，以及实施标准化结局测量的复杂性。
结论
参与唇腭裂护理的提供者、工作人员和照顾者认为标准化结局测量有多种益处，但也认识到其实施存在实质性障碍。本研究的结果可用于指导标准化结局测量的实施策略的制定，该策略建立在干预措施的感知优势的基础上，并减少感知障碍。
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