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创伤审核工具在印度城市中的感知有用性:一项使用 WHO 及中低收入国家创伤审核工具的混合方法多中心德尔菲研究

Perceived usefulness of trauma audit filters in urban India: a mixed-methods multicentre Delphi study comparing filters from the WHO and low and middle-income countries.

机构信息

Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden

Department of Emergency and Internal Medicine, Skane University Hospital, Malmo, Sweden.

出版信息

BMJ Open. 2022 Jun 9;12(6):e059948. doi: 10.1136/bmjopen-2021-059948.

Abstract

OBJECTIVE

To compare experts' perceived usefulness of audit filters from Ghana, Cameroon, WHO and those locally developed; generate context-appropriate audit filters for trauma care in selected hospitals in urban India; and explore characteristics of audit filters that correlate to perceived usefulness.

DESIGN

A mixed-methods approach using a multicentre online Delphi technique.

SETTING

Two large tertiary hospitals in urban India.

METHODS

Filters were rated on a scale from 1 to 10 in terms of perceived usefulness, with the option to add new filters and comments. The filters were categorised into three groups depending on their origin: low and middle-income countries (LMIC), WHO and New (locally developed), and their scores compared. Significance was determined using Kruskal-Wallis test followed by Wilcoxon rank-sum test. We performed a content analysis of the comments.

RESULTS

26 predefined and 15 new filter suggestions were evaluated. The filters had high usefulness scores (mean overall score 9.01 of 10), with the LMIC filters having significantly higher scores compared with those from WHO and those newly added. Three themes were identified in the content analysis relating to , and .

CONCLUSIONS

Audit filters from other LMICs were deemed highly useful in the urban India context. This may indicate that the transferability of defined trauma audit filters between similar contexts is high and that these can provide a starting point when implemented as part of trauma quality improvement programmes in low-resource settings.

摘要

目的

比较加纳、喀麦隆、世界卫生组织和当地开发的审计筛选器在专家中的感知有用性;为选定的印度城市医院创伤护理生成适合上下文的审计筛选器;并探索与感知有用性相关的审计筛选器的特征。

设计

使用多中心在线 Delphi 技术的混合方法。

地点

印度城市的两家大型三级医院。

方法

根据感知有用性,将筛选器从 1 到 10 进行评分,并可选择添加新的筛选器和评论。根据其来源,将筛选器分为三组:中低收入国家(LMIC)、世界卫生组织和新(本地开发),并比较其得分。使用 Kruskal-Wallis 检验 followed by Wilcoxon 秩和检验确定显著性。我们对评论进行了内容分析。

结果

评估了 26 个预定义和 15 个新的筛选器建议。筛选器具有较高的有用性评分(总体评分为 10 的 9.01),与来自世界卫生组织和新添加的筛选器相比,来自中低收入国家的筛选器得分明显更高。内容分析中确定了三个主题,分别与 、 和 有关。

结论

其他中低收入国家的审计筛选器在印度城市环境中被认为非常有用。这可能表明,在类似背景下,定义明确的创伤审计筛选器的可转移性很高,并且当它们作为低资源环境中创伤质量改进计划的一部分实施时,可以作为起点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e33d/9185581/1c8fbd5d3ae8/bmjopen-2021-059948f01.jpg

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