Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium.
Department of Family Medicine and Chronic Care, Free University of Brussels, Brussels, Belgium.
Prim Health Care Res Dev. 2023 Feb 8;24:e12. doi: 10.1017/S1463423622000767.
To use normalization process theory (NPT) to build a strategy for the implementation of goal-oriented care (GOC) in primary care in Flanders, Belgium.
GOC is a possible approach to more coordinated and integrated care and tailors care to patients' personal life goals. The concept has gained interest among policy makers and researchers, but the main drivers for successful implementation are the primary healthcare professionals (PHCPs) who need to see added value of GOC in order to embed it into their daily practice. NPT, developed to understand the processes of implementing new ways of organizing care, offers a useful lens to understand adoption of GOC in primary care practice.
PHCPs ( = 131) who participated in a 2-hour community meeting on GOC were asked to complete the Normalization MeAsure Development survey. This 23-item survey is based on NPT and describes participants' views about how an intervention would impact their work, their expectations about it, and whether it could become a routine part of their work.
The NPT constructs coherence (sense-making work) and cognitive participation (relational work) showed positive tendency toward implementation of GOC. The participants had an initial understanding on GOC and there was much interest in supporting and start working with this approach. The other constructs collective action (operational work) and reflexive monitoring (appraisal work) will need further efforts to trigger implementation. A common ground is needed to integrate GOC as a common practice which can be achieved by intensive interprofessional collaboration.
运用规范化进程理论（NPT）为比荷卢经济联盟佛兰德斯地区的基层医疗实施目标导向护理（GOC）制定实施策略。
GOC 是一种更协调、更综合的护理方法，它根据患者的个人生活目标来调整护理方案。该理念已引起政策制定者和研究人员的关注，但成功实施的主要驱动力是基层医疗保健专业人员（PHCP），他们需要看到 GOC 的附加价值，才能将其纳入日常实践。NPT 旨在理解实施新的护理组织方式的过程，为理解 GOC 在基层医疗实践中的采用提供了有用的视角。
参加 GOC 两小时社区会议的 PHCP（=131）被要求完成规范化措施发展调查。该 23 项调查基于 NPT，描述了参与者对干预措施如何影响他们工作的看法、对其的期望，以及它是否可以成为他们工作的常规部分。
NPT 结构中的一致性（意义构建工作）和认知参与（关系构建工作）表现出对 GOC 实施的积极倾向。参与者对 GOC 有初步的了解，并对支持和开始使用这种方法很感兴趣。其他结构的集体行动（操作工作）和反思性监测（评估工作）需要进一步努力来推动实施。需要建立一个共同基础，将 GOC 整合为一种共同实践，可以通过强化的跨专业合作来实现。
