Sood Akshay, Pollard Charles, Kalishman Summers, Assad Nour, LeSuer Kyla, Khattar Ramni, Soller Brian, Myers Orrin
Department of Internal Medicine and.
Black Lung Program, Miners' Colfax Medical Center, Raton, New Mexico.
ATS Sch. 2020 Dec 22;2(1):66-83. doi: 10.34197/ats-scholar.2020-0073OC.
Given the reemergence of pneumoconiosis in the United States, there is a tremendous need to train rural professionals in its multidisciplinary management. The Miners' Wellness TeleECHO (Telementoring Extension for Community Health Outcomes) Program in New Mexico, United States, provides longitudinal multidisciplinary telementoring to professionals taking care of miners. The impact of this approach has not been previously evaluated. To examine the change in self-efficacy of professionals taking care of miners and participating in the TeleECHO Program. This is a 12-month longitudinal study involving clinical and nonclinical professionals caring for miners. The study outcome was the change in self-efficacy scores, using a customized instrument of 14 measures grouped into three domains: clinical, medicolegal, and soft skills. The primary outcome used a retrospective pre-post design that collects "pretest" data at the postintervention timeframe. Participants reported significant improvements in 10 of 14 items ( < 0.05) and a significant decline in 1 of 14 items (with respect to their ability to interpret pulmonary function test results, < 0.001) since their start dates in the program. Subjects also reported significant improvement with respect to their scores for all three domains and for the 14-item total score ( ⩽ 0.01). Existing participants and clinical professional groups demonstrated greater improvement in selected items than fresh participants and nonclinical professional groups, respectively. This study is the first in a stepwise approach to determine the benefit of participating in a multidisciplinary telementoring intervention by improving participant self-efficacy in caring for miners with complex mining-related diseases. Our study finding represents a potential solution to a growing access-to-care gap for miners with pneumoconiosis.
鉴于尘肺病在美国再度出现，迫切需要对农村专业人员进行多学科管理方面的培训。美国新墨西哥州的矿工健康远程ECHO（社区健康成果远程指导扩展）项目为照顾矿工的专业人员提供长期多学科远程指导。此前尚未评估这种方法的效果。为了研究照顾矿工并参与远程ECHO项目的专业人员自我效能的变化。这是一项为期12个月的纵向研究，涉及照顾矿工的临床和非临床专业人员。研究结果是自我效能得分的变化，使用一种定制工具，该工具包含14项指标，分为三个领域：临床、法医学和软技能。主要结果采用回顾性前后设计，在干预后时间框架内收集“预测试”数据。自参与该项目以来，参与者报告称，14项指标中有10项有显著改善（<0.05），14项指标中有1项显著下降（关于他们解读肺功能测试结果的能力，<0.001）。受试者还报告称，他们在所有三个领域的得分以及14项总分均有显著提高（⩽0.01）。现有参与者和临床专业组在选定项目上的改善分别比新参与者和非临床专业组更大。本研究是确定参与多学科远程指导干预的益处的逐步方法中的第一步，通过提高参与者照顾患有复杂采矿相关疾病矿工的自我效能来实现。我们的研究结果代表了一种潜在的解决方案，以应对尘肺病矿工在获得医疗服务方面日益扩大的差距。
