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北爱尔兰将高级护理人员引入初级医疗保健:对全科医生经历的定性描述性研究

The introduction of advanced paramedics into primary care in Northern Ireland: a qualitative descriptive study of the experiences of general practitioners.

作者信息

Muldoon Damian, Seenan Chris

机构信息

Northern Ireland Ambulance Service.

Glasgow Caledonian University.

出版信息

Br Paramed J. 2021 Dec 1;6(3):1-6. doi: 10.29045/14784726.2021.12.6.3.1.

Abstract

BACKGROUND

Primary care is dealing with an ever-increasing workload. The causes are multi-factorial but include a decreasing number of General Practitioners (GPs), combined with increased numbers of patients with multiple co-morbidities and an ageing population. As a result of these pressures, nursing and allied health professionals are now working within a growing number of advanced practice roles delivering community-based care. One such example is paramedics taking up advanced roles within General Practice settings in Northern Ireland. What is not known, however, is what GPs' experiences are of these developments.

AIMS

To examine the experiences of GPs who have introduced an advanced paramedic into their primary care team in Northern Ireland.

DESIGN

A qualitative descriptive design was chosen as the most suitable approach to allow participants to relay their experiences in their own words within the loose confines of a semi-structured interview.

METHODS

Semi-structured interviews were conducted with a group of four purposively selected GPs who had direct experience of the phenomena of interest. These interviews were transcribed verbatim, anonymised and then analysed thematically.

RESULTS

The thematic analysis produced three superordinate themes of , and . These were underpinned by seven ordinate themes that were supported using verbatim quotes. These were then discussed and contextualised with themes from existing literature.

CONCLUSION

Generally, there was widespread support from the GPs for the introduction of advanced paramedics into primary care teams. The reasons were multi-factorial but the reduction in GP workload featured prominently. The participants reported benefits in terms of increased resilience and work-life balance. The capacity to provide a clinician with experience of dealing with acute and emergency presentations, in combination with managing routine procedures, was also reported to be of great importance.

摘要

背景

基层医疗面临的工作量不断增加。其原因是多方面的,但包括全科医生数量减少,同时患有多种合并症的患者数量增加以及人口老龄化。由于这些压力,护理和专职医疗专业人员现在在越来越多的高级实践角色中工作,提供基于社区的护理。一个这样的例子是护理人员在北爱尔兰的全科医疗环境中担任高级角色。然而,尚不清楚的是全科医生对这些发展的体验如何。

目的

研究在北爱尔兰将高级护理人员引入其基层医疗团队的全科医生的体验。

设计

选择定性描述性设计作为最合适的方法,以便参与者在半结构化访谈的宽松范围内用自己的语言讲述他们的经历。

方法

对一组四名有目的地挑选的、对感兴趣的现象有直接经验的全科医生进行了半结构化访谈。这些访谈逐字记录、匿名处理,然后进行主题分析。

结果

主题分析产生了三个上位主题……以及……。这些主题由七个下位主题支撑,并使用逐字引述加以支持。然后将这些与现有文献中的主题进行讨论并结合背景情况。

结论

总体而言,全科医生普遍支持将高级护理人员引入基层医疗团队。原因是多方面的,但全科医生工作量的减少是一个突出因素。参与者报告称在恢复力增强和工作与生活平衡方面有好处。还报告称,让临床医生具备处理急性和紧急情况以及管理常规程序经验的能力也非常重要。

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