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技术支持的营养护理模式:卫生服务提供者的观点。

Technology-supported models of nutrition care: Perspectives of health service providers.

作者信息

Barnett Amandine, Kelly Jaimon T, Wright Charlene, Campbell Katrina L

机构信息

Centre for Online Health, The University of Queensland, Brisbane, QLD, Australia.

Centre for Health Services Research, The University of Queensland, Brisbane, QLD, Australia.

出版信息

Digit Health. 2022 Jun 3;8:20552076221104670. doi: 10.1177/20552076221104670. eCollection 2022 Jan-Dec.

Abstract

OBJECTIVE

To determine the perspectives to the adoption, scale-up, sustainability, and spread of technology-supported models of nutrition care, in hospital and ambulatory care settings.

METHODS

Thirty-one health service providers participated in individual semi-structured interviews from a tertiary health service in Queensland, Australia. The Non-adoption, Abandonment, and challenges to the Scale up, Spread and Sustainability (NASSS) framework, designed to evaluate technology-supported models' success, informed the qualitative design.

RESULTS

Key findings were that technology-supported models of care could benefit many chronic condition patient groups; dietitians are well suited to adopting this technology: and the value proposition in creating efficiency gains in the health service. However, challenges of transitioning and sustainability were identified. Perceived enablers for technology supported models of care included: previous intentions for technology supported models of care prior to the 2019 novel coronavirus pandemic; opportunity for clinicians to complete higher valued tasks; and integration of technology systems and assisted staff roles. Perceived barriers included: suitability for patients is dependent on experience and ability to use technology, varied confidence by clinicians when conducting clinical assessments; high investment required for set up and ongoing maintenance; and patients desire for adopting face-to-face care over technology. Health service providers perceived that embedding and adapting such models requires maintenance of high-quality service and continued research.

CONCLUSIONS

Health service providers recognize adopting, scaling, and sustaining technology-supported models of nutrition care benefits patients, clinicians, and health services in general. Robust clinical trials and health service evaluations of technology-supported models of care, across practice settings are now needed.

摘要

目的

确定在医院和门诊护理环境中,对于采用、扩大规模、维持以及推广技术支持的营养护理模式的观点。

方法

31名医疗服务提供者参与了来自澳大利亚昆士兰州一家三级医疗服务机构的个人半结构化访谈。旨在评估技术支持模式成功与否的非采用、放弃以及扩大规模、推广和可持续性的挑战(NASSS)框架为定性设计提供了依据。

结果

主要发现包括,技术支持的护理模式可使许多慢性病患者群体受益;营养师非常适合采用这项技术;以及在医疗服务中提高效率所带来的价值主张。然而,也发现了转型和可持续性方面的挑战。技术支持的护理模式的感知促进因素包括:在2019年新型冠状病毒大流行之前对技术支持的护理模式的先前意向;临床医生有机会完成更具价值的任务;以及技术系统的整合和辅助人员的角色。感知到的障碍包括:对患者的适用性取决于使用技术的经验和能力,临床医生在进行临床评估时信心各异;设立和持续维护需要高额投资;以及患者更倾向于采用面对面护理而非技术手段。医疗服务提供者认为,嵌入和调整此类模式需要维持高质量服务并持续开展研究。

结论

医疗服务提供者认识到采用、扩大规模并维持技术支持的营养护理模式总体上对患者、临床医生和医疗服务有益。现在需要在不同实践环境中对技术支持的护理模式进行强有力的临床试验和医疗服务评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d389/9168874/4d032083d757/10.1177_20552076221104670-fig1.jpg

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