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哪些因素影响公立医院环境下的专职医疗人员参与研究:一种基于理论的定性研究方法。

What influences allied health clinician participation in research in the public hospital setting: a qualitative theory-informed approach.

作者信息

Wenke Rachel, Noble Christy, Weir Kelly A, Mickan Sharon

机构信息

Allied Health Services, Gold Coast Hospital and Health Service, Southport, Queensland, Australia

School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia.

出版信息

BMJ Open. 2020 Aug 20;10(8):e036183. doi: 10.1136/bmjopen-2019-036183.

Abstract

OBJECTIVES

Using theoretical frameworks from implementation science, we aimed to systematically explore the barriers and enablers to research active allied health professionals (AHP) participating and leading research in the hospital setting.

DESIGN

A qualitative interview study informed by behaviour change theory.

SETTING

Single Australian tertiary hospital and health service.

PARTICIPANTS

We recruited a convenience sample of 21 AHPs working within a hospital who were seeking to actively participate in/or lead research within their workplace.

DATA COLLECTION

Semistructured interviews explored perceived barriers and enablers to research participation, informed by the 14 domains of the theoretical domains framework (TDF). Transcribed interviews were deductively coded and mapped to the TDF. A deeper level of inductive coding was used to identify emergent themes that influenced behaviour change, according to the three key constructs of: capability, opportunity and motivation (COM-B).

RESULTS

Barriers and enablers to research participation were identified within nine predominant domains of the TDF. Most enablers to engaging in research related to the motivation or opportunity constructs of the COM-B. These enablers included positive beliefs about the consequences of research participation, enabling social influences, peer support and motivation for skill development and to inform practice. Predominant barriers related to environmental context and resources (eg, reduced funding or time), emotional responses of being overwhelmed and perceptions of reduced capability.

CONCLUSION

This study identified key barriers and enablers to behaviour change related to AHPs participating and/or leading research. Motivation and opportunities to participate in research may be enabled by maximising social influence opportunities, reiterating beliefs about positive consequences of research and considering AHP's emotional responses. Implementation science frameworks may provide a more systematic and holistic understanding of factors which influence research participation including enhancing knowledge, motivation and opportunity.

摘要

目的

运用实施科学的理论框架,我们旨在系统地探究研究活跃的专职医疗人员(AHP)在医院环境中参与和引领研究的障碍与促进因素。

设计

一项基于行为改变理论的定性访谈研究。

背景

澳大利亚一家三级医院及医疗服务机构。

参与者

我们招募了21名在医院工作且寻求积极参与/或引领其工作场所研究的AHP,组成便利样本。

数据收集

半结构化访谈依据理论领域框架(TDF)的14个领域,探究了研究参与的感知障碍与促进因素。转录后的访谈进行了演绎编码并映射到TDF。根据能力、机会和动机(COM - B)这三个关键构建,运用更深层次的归纳编码来识别影响行为改变的新出现主题。

结果

在TDF的九个主要领域中确定了研究参与的障碍与促进因素。大多数参与研究的促进因素与COM - B的动机或机会构建相关。这些促进因素包括对研究参与后果的积极信念、有利的社会影响、同伴支持以及技能发展和为实践提供信息的动机。主要障碍与环境背景和资源(如资金或时间减少)、不堪重负的情绪反应以及能力降低的认知有关。

结论

本研究确定了与AHP参与和/或引领研究相关的行为改变的关键障碍与促进因素。通过最大化社会影响机会、重申对研究积极后果的信念以及考虑AHP的情绪反应,可能会促进参与研究的动机和机会。实施科学框架可能会对影响研究参与的因素提供更系统和全面的理解,包括增强知识、动机和机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55f3/7443264/21db65158a55/bmjopen-2019-036183f01.jpg

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