医疗保健专业人员提供个性化和整体护理的观点：使用理论领域框架。
Healthcare professionals' perspective on delivering personalised and holistic care: using the Theoretical Domains Framework.
机构信息
Monash Sustainable Development Institute, BehaviourWorks Australia, Monash University, Melbourne, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
出版信息
BMC Health Serv Res. 2022 Mar 1;22(1):281. doi: 10.1186/s12913-022-07630-1.
BACKGROUND
Interventions to improve personalised and holistic care delivery by healthcare professionals are more likely to be effective if they target the factors influencing specific behaviours. This study reports on the development and testing of a questionnaire to identify perspectives of healthcare professionals' personalised and holistic care behaviours based on the Theoretical Domains Framework.
METHODS
The study was conducted in public health services in Victoria, Australia. The questionnaire was developed and pilot-tested with behaviour change researchers and healthcare professionals. Doctors, nurses and midwives were recruited via notices and email invitations from Safer Care Victoria's website and mailing lists of healthcare professionals and invited to completed the questionnaire online (hosted on Qualtrics). Health services administrators and allied health professionals were excluded from the study. Confirmatory factor analysis was undertaken to generate the model of best fit and group differences were tested using univariate tests.
RESULTS
One hundred and four healthcare professionals from public health services in Victoria, Australia, completed the 39-item questionnaire focusing on specific personalised and holistic care behaviours. The final model consisted of 13 factors and 39 items, and CFA produced an acceptable fit, as well as adequate levels of discriminant validity and internal consistency (α = 0.60 to 0.84). Seven domains, "social influence", "motivation & goals", "environmental context and resources', "skills", 'beliefs about consequences", "behaviour regulation" and "nature of behaviour" were identified. Significant differences in the factors influencing these behaviours were found in groups with different years of experience and role seniority. These findings suggest that future interventions need to be targeted to specific groups.
CONCLUSION
This study identified the specific behaviours and the factors associated with performance of personalised and holistic care among healthcare professionals. The findings suggest several interventions and policy functions may be taken to improve personalised and holistic care.
背景
如果干预措施针对影响特定行为的因素，那么提高医疗保健专业人员提供个性化和整体护理的效果就更有可能。本研究报告了根据理论领域框架开发和测试一种问卷的情况，该问卷旨在确定医疗保健专业人员个性化和整体护理行为的观点。
方法
该研究在澳大利亚维多利亚州的公共卫生服务机构进行。该问卷由行为改变研究人员和医疗保健专业人员共同开发和试点测试。医生、护士和助产士通过 Safer Care Victoria 网站上的通知和电子邮件邀请以及医疗保健专业人员的邮件列表招募，并被邀请在线完成问卷（在 Qualtrics 上托管）。卫生服务管理人员和联合卫生专业人员被排除在研究之外。进行了验证性因素分析以生成最佳拟合模型，并使用单变量检验测试了组间差异。
结果
来自澳大利亚维多利亚州公共卫生服务的 104 名医疗保健专业人员完成了针对特定个性化和整体护理行为的 39 项问卷。最终模型由 13 个因素和 39 个项目组成，CFA 产生了可接受的拟合度，以及足够的判别有效性和内部一致性（α=0.60 至 0.84）。确定了七个领域，即“社会影响”、“动机和目标”、“环境背景和资源”、“技能”、“对后果的信念”、“行为调节”和“行为本质”。在具有不同工作经验和角色资历的群体中，发现这些行为的影响因素存在显著差异。这些发现表明，未来的干预措施需要针对特定群体。
结论
本研究确定了医疗保健专业人员提供个性化和整体护理的具体行为和相关因素。研究结果表明，可能需要采取一些干预措施和政策职能来改善个性化和整体护理。
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