2017 年加纳莱基马医院促进和维持传统、补充和综合医学服务使用的因素：一项观察性研究。
Factors that promote and sustain the use of traditional, complementary and integrative medicine services at LEKMA hospital, Ghana, 2017: an observational study.
机构信息
School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.
Ghana Field Epidemiology and Laboratory Training Program (GFELTP), Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.
出版信息
BMC Complement Med Ther. 2021 Jan 6;21(1):14. doi: 10.1186/s12906-020-03185-y.
BACKGROUND
About 70% of Ghanaians depend on traditional, complementary and integrative medicine (TCIM) practices for primary healthcare needs. It was therefore integrated into mainstream healthcare delivery system by the Ministry of Health in September 2012. LEKMA hospital was one of the institutions for piloting TCIM services. We assessed factors that promote the usage and sustainability of TCIM services within the formal healthcare system.
METHODS
We conducted a cross-sectional study from April-June 2017 at the LEKMA hospital, Accra, Ghana. Patients and managers of TCIM clinic were interviewed. Data was collected through qualitative and quantitative approaches. We defined usage of TCIM as its current use, and sustainability as structures in place to run TCIM services. For assessing usage, a five-point Likert scale was used to assess five domain areas via exit interviews. Managers were assessed on the sustainability of TCIM services through in-depth interviews. Likert scales responses were analysed quantitatively using descriptive tertile statistics. Thematic analysis was used for qualitative analysis.
RESULTS
Overall, 72.7% (40/55) of the clients showed a high preference for TCIM usage and 80.0% (4/5) of the managers valued it as partially sustainable. Eighty per cent (44/55) of patients indicated that the location of TCIM services and availability of visible directional signs influenced the good usage; 84% (46/55) of the patients agreed that the usage of TCIM was influenced by their perceived effectiveness. Managers indicated that human resources for providing services was a challenge and TCIM integration into the operations of the hospital needed to be improved.
CONCLUSION
We observed a high preference for usage of TCIM among users at LEKMA hospital. The general belief in the potency, perceived effectiveness, location and availability of TCIM services are key determinants of the high preference for usage of TCIM. Provision of TCIM services in its current form is partially sustainable from the managers' perspective. We recommend that the Ministry of Health ensures the availability of staff and create awareness of TCIM services among the general populace.
背景
约 70%的加纳人依赖传统、补充和综合医学（TCIM）实践来满足初级医疗保健需求。因此，卫生部于 2012 年 9 月将其纳入主流医疗保健提供系统。LEKMA 医院是试点 TCIM 服务的机构之一。我们评估了促进 TCIM 服务在正规医疗保健系统中使用和可持续性的因素。
方法
我们于 2017 年 4 月至 6 月在加纳阿克拉的 LEKMA 医院进行了一项横断面研究。对 TCIM 诊所的患者和管理人员进行了访谈。通过定性和定量方法收集数据。我们将 TCIM 的使用定义为当前使用，可持续性定义为用于运行 TCIM 服务的结构。为了评估使用情况，通过出口访谈使用五点李克特量表评估五个领域。通过深入访谈评估管理人员对 TCIM 服务可持续性的看法。李克特量表的回答通过描述性三分位统计进行定量分析。对定性分析采用主题分析法。
结果
总体而言，55 名患者中有 72.7%（40/55）表现出对 TCIM 使用的高度偏好，5 名管理人员中有 80.0%（4/5）认为其部分可持续。80%（44/55）的患者表示 TCIM 服务的位置和可见的定向标志的可用性影响了良好的使用；84%（46/55）的患者同意 TCIM 的使用受到他们对有效性的看法的影响。管理人员表示，提供服务的人力资源是一个挑战，TCIM 需要融入医院的运营。
结论
我们观察到 LEKMA 医院的患者对 TCIM 的使用有很高的偏好。对 TCIM 效力、有效性、位置和可用性的普遍信念是对 TCIM 使用高度偏好的关键决定因素。从管理人员的角度来看，TCIM 服务的当前形式提供具有部分可持续性。我们建议卫生部确保工作人员的可用性，并在普通民众中提高对 TCIM 服务的认识。
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