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对前往埃塞俄比亚和肯尼亚的耳鼻喉头颈外科短期外科手术访问的双向需求评估。

Bidirectional needs assessment of otolaryngology-head and neck surgery short-term surgical trips to Ethiopia and Kenya.

作者信息

Chweya Cynthia M, Ryder C Yoonhee, Fei-Zhang David J, Green Katerina J, Zemene Yilkal, Okerosi Samuel, Wiedermann Joshua P

机构信息

Department of Otolaryngology-Head and Neck Surgery University of Kansas Medical Center Kansas City Kansas USA.

University of Michigan Medical School Ann Arbor Michigan USA.

出版信息

Laryngoscope Investig Otolaryngol. 2023 Jan 25;8(1):303-312. doi: 10.1002/lio2.1014. eCollection 2023 Feb.

Abstract

OBJECTIVES

To create an otolaryngology-specific needs assessment tool for short-term global surgical trips and to describe our findings from its implementation.

METHODS

Surveys 1 and 2 were developed based on a literature review and disseminated to Low-Middle Income (LMIC) hosting institutions in Kenya and Ethiopia and to High-Income surgical trip participants (HIC), respectively. Respondents were otolaryngologists identified online, through professional organizations, and by word-of-mouth, who had participated in a surgical trip of <4 weeks.

RESULTS

HIC and LMIC respondents shared similar goals of expanding host surgical skills through education and training while building sustainable partnerships. Discrepancies were identified between LMIC desired surgical skills and supply needs and HIC current practices. Microvascular reconstruction (17.6%), advanced otologic surgery (17.6%), and FESS (14.7%) were most desired skills and high-demand equipment needs were FESS sets (89%), endoscopes (78%), and surgical drills (56%). Frequently taught techniques included advanced otologic surgery (36.6%), congenital anomaly surgery (14.6%), and FESS (14.6%) with the largest gap between LMIC-need and HIC-offerings being in microvascular reconstruction (17.6% vs. 0%). We also highlight the discrepancy in expectations of responsibility for trip logistics, research, and patient follow-up.

CONCLUSION

We created and implemented the first otolaryngology-specific needs assessment tool in the literature. With its implementation in Ethiopia and Kenya, we were able to identify unmet needs as well as attitudes and perceptions of LMIC and HIC participants. This tool may be adapted and utilized to assess specific needs, resources, and goals of both host and visiting teams to facilitate successful global partnerships.

LEVEL OF EVIDENCE

Level VI.

摘要

目的

创建一个针对短期全球外科手术之旅的耳鼻喉科特定需求评估工具,并描述其实施后的结果。

方法

基于文献综述开发了调查问卷1和调查问卷2,分别分发给肯尼亚和埃塞俄比亚的中低收入(LMIC)接待机构以及高收入外科手术之旅参与者(HIC)。受访者是通过在线、专业组织和口碑确定的耳鼻喉科医生,他们参加过为期不到4周的外科手术之旅。

结果

HIC和LMIC受访者在通过教育和培训扩展接待方手术技能以及建立可持续伙伴关系方面有着相似的目标。在LMIC期望的手术技能和供应需求与HIC当前的做法之间发现了差异。微血管重建(17.6%)、高级耳科手术(17.6%)和功能性鼻内镜鼻窦手术(FESS,14.7%)是最需要的技能,高需求的设备是FESS套件(89%)、内窥镜(78%)和手术钻(56%)。经常教授的技术包括高级耳科手术(36.6%)、先天性异常手术(14.6%)和FESS(14.6%),LMIC需求与HIC提供之间差距最大的是微血管重建(17.6%对0%)。我们还强调了在旅行后勤、研究和患者随访责任期望方面的差异。

结论

我们创建并实施了文献中首个针对耳鼻喉科的特定需求评估工具。通过在埃塞俄比亚和肯尼亚实施该工具,我们能够识别未满足的需求以及LMIC和HIC参与者的态度和看法。该工具可进行调整并用于评估接待方和来访团队的特定需求、资源和目标,以促进成功的全球伙伴关系。

证据级别

六级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1784/9948567/4b2c1a6f6404/LIO2-8-303-g005.jpg

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