National Health and Medical Research Council Centre for Research Excellence in Severe Asthma and The Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, New South Wales, Australia.
School of Nursing and Midwifery, The University of Newcastle, Newcastle, New South Wales, Australia.
PLoS One. 2022 Jun 7;17(6):e0269038. doi: 10.1371/journal.pone.0269038. eCollection 2022.
Whilst multidimensional assessment enables the detection of treatable traits in severe asthma and has the potential to improve patient outcomes, healthcare disparities exist, and little is known about the factors influencing optimal management in severe asthma. This study aimed to explore perceived barriers, and enablers to implementing personalised care in severe asthma, from the healthcare professionals' perspective.
A descriptive, qualitative study involving a single focus group (n = 7) and semi-structured interviews (n = 33) with multidisciplinary healthcare professionals involved in severe asthma care was conducted. A hybrid thematic and content analysis was undertaken to identify themes, which were then deductively mapped to the Theoretical Domains Framework (TDF).
Overall, three emergent themes were identified: (1) Barriers- (2) Enablers- to optimal management; (3) Desired model of care. Across all TDF domains, 6 constructs influenced development and implementation of optimal care: (1) belief about consequences, (2) environmental context and resources, (3) belief about capabilities, (4) social/professional role and identity, (5) goals and (6) knowledge.
Implementation of personalised care in severe asthma is complex and non-linear. The use of a theory-based approach effectively demonstrated how a variety of behaviours could be targeted to optimise and promote personalised care in different clinical setting.
多维评估能够发现严重哮喘中的可治疗特征,并有潜力改善患者的预后,但存在医疗保健差异,并且对于影响严重哮喘最佳管理的因素知之甚少。本研究旨在从医疗保健专业人员的角度探讨实施严重哮喘个体化护理的感知障碍和促进因素。
进行了一项描述性、定性研究,涉及 7 名多学科医疗保健专业人员的单一焦点小组(n = 7)和半结构化访谈(n = 33)。采用混合主题和内容分析法来确定主题,然后根据理论领域框架(TDF)进行演绎映射。
总体而言,确定了三个新兴主题:(1)严重哮喘管理的障碍-促进因素;(2)理想的护理模式。在所有 TDF 领域中,有 6 个结构影响了最佳护理的发展和实施:(1)对后果的信念,(2)环境背景和资源,(3)对能力的信念,(4)社会/专业角色和身份,(5)目标和(6)知识。
严重哮喘个体化护理的实施是复杂且非线性的。使用基于理论的方法有效地展示了如何针对各种行为进行靶向,以在不同的临床环境中优化和促进个体化护理。