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艾滋病毒专家和心脏病专家对艾滋病毒感染者专科转诊流程的看法:一项定性描述性研究。

Perspectives of HIV specialists and cardiologists on the specialty referral process for people living with HIV: a qualitative descriptive study.

机构信息

Department of Population Health Sciences, Duke University School of Medicine, 215 Morris St., Suite 210, Durham, NC, 27701, USA.

Duke Global Health Institute, Duke University, Durham, NC, USA.

出版信息

BMC Health Serv Res. 2022 May 9;22(1):623. doi: 10.1186/s12913-022-08015-0.

Abstract

BACKGROUND

Cardiology care may be beneficial for risk factor management in people living with HIV (PLWH), yet limited information is available about the referral process from the perspectives of HIV specialists and cardiologists.

METHODS

We conducted 28 qualitative interviews at academic medical centers in the United States from December 2019 to February 2020 using components of the Specialty Referral Process Framework: referral decision, entry into referral care, and care integration. We analyzed the data using applied thematic analysis.

RESULTS

Reasons for cardiology referral most commonly included secondary prevention, uncontrolled risk factors, cardiac symptoms, and medication management. Facilitators in the referral process included ease of referral, personal relationships between HIV specialists and cardiologists, and close proximity of the clinic to the patient's home. Barriers included lack of transportation, transportation costs, insurance coverage gaps, stigma, and patient reluctance.

CONCLUSIONS

Our results will inform future studies on implementation strategies aimed at improving the specialty referral process for PLWH.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT04025125 .

摘要

背景

心脏病学护理可能有益于艾滋病毒感染者(PLWH)的危险因素管理,但从 HIV 专家和心脏病专家的角度来看,关于转诊过程的信息有限。

方法

我们于 2019 年 12 月至 2020 年 2 月在美国的学术医疗中心进行了 28 次定性访谈,使用专业转诊流程框架的组成部分:转诊决策、转诊护理进入和护理整合。我们使用应用主题分析对数据进行了分析。

结果

心脏病学转诊的常见原因包括二级预防、未控制的危险因素、心脏症状和药物管理。转诊过程中的促进因素包括转诊的便利性、HIV 专家和心脏病专家之间的个人关系以及诊所与患者家的距离。障碍包括交通不便、交通费用、保险覆盖缺口、耻辱感和患者的不情愿。

结论

我们的研究结果将为旨在改善 PLWH 专业转诊流程的未来研究提供信息。

试验注册

ClinicalTrials.gov 标识符:NCT04025125。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6814/9082896/81a404bfc998/12913_2022_8015_Fig1_HTML.jpg

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