儿科门诊护理中的即时诊断技术：对英国临床医生和利益相关者的定性访谈研究。
Point-of-care diagnostic technology in paediatric ambulatory care: a qualitative interview study of English clinicians and stakeholders.
机构信息
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, UK
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, UK.
出版信息
BMJ Open. 2022 Jun 7;12(6):e059103. doi: 10.1136/bmjopen-2021-059103.
UNLABELLED
Point-of-care (POC) tests have the potential to improve paediatric healthcare. However, both the development and evaluation of POC technology have almost solely been focused on adults. We aimed to explore frontline clinicians' and stakeholders' current experience of POC diagnostic technology in children in England; and to identify areas of unmet need.
DESIGN, SETTING AND PARTICIPANTS: Qualitative semistructured telephone interviews were carried out with purposively sampled participants from clinical paediatric ambulatory care and charity, industry and policymaking stakeholders. The interviews were audio-recorded, transcribed and analysed thematically.
RESULTS
We interviewed 19 clinicians and 8 stakeholders. The main perceived benefits of POC tests and technologies were that they aided early decision-making and could be convenient and empowering when used independently by patients and families. Clinicians and stakeholders wanted more POC tests to be available for use in clinical practice. Most recognised that play and reward are important components of successful POC tests for children. Clinicians wanted tests to give them answers, which would result in a change in their clinical management. Detecting acute serious illness, notably distinguishing viral and bacterial infection, was perceived to be an area where tests could add value. POC tests were thought to be particularly useful for children presenting atypically, where diagnosis was more challenging, such as those less able to communicate, and for rare serious diseases. Many participants felt they could be useful in managing chronic disease.
CONCLUSIONS
This exploratory study found that clinicians and stakeholders supported the use of diagnostic POC technology in paediatric ambulatory care settings in England. Some existing tests are not fit for purpose and could be refined. Industry should be encouraged to develop new child-friendly tests tackling areas of unmet need, guided by the preferred characteristics of those working on the ground.
未加标签
床边即时检测（POC）有潜力改善儿科医疗保健。然而，POC 技术的开发和评估几乎完全集中在成年人身上。我们旨在探索英格兰一线临床医生和利益相关者目前对儿童 POC 诊断技术的体验；并确定未满足的需求领域。
设计、背景和参与者：采用有针对性的抽样方法，从临床儿科门诊护理和慈善机构、行业和政策制定利益相关者中选取参与者，进行半结构式电话访谈。对访谈进行了录音、转录和主题分析。
结果
我们采访了 19 名临床医生和 8 名利益相关者。POC 测试和技术的主要预期好处是它们有助于早期决策，并且当患者和家属独立使用时可以方便且赋权。临床医生和利益相关者希望更多的 POC 测试可用于临床实践。大多数人认识到，对于儿童来说，游戏和奖励是成功的 POC 测试的重要组成部分。临床医生希望测试能够为他们提供答案，从而改变他们的临床管理。检测急性严重疾病，尤其是区分病毒和细菌感染，被认为是测试可以增值的领域。POC 测试被认为对表现不典型的儿童特别有用，在这些儿童中，诊断更具挑战性，例如那些沟通能力较弱的儿童，以及那些患有罕见严重疾病的儿童。许多参与者认为它们在管理慢性病方面可能有用。
结论
这项探索性研究发现，临床医生和利益相关者支持在英格兰儿科门诊护理环境中使用诊断 POC 技术。一些现有的测试不适合用途，可以进行改进。应鼓励行业根据实地工作者的首选特征，开发针对未满足需求领域的新的适合儿童的测试。
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