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南非林波波省接受NIMART培训的护士加强艾滋病毒与非传染性疾病综合管理的概念模型

A Conceptual Model to Strengthen Integrated Management of HIV and NCDs among NIMART-Trained Nurses in Limpopo Province, South Africa.

作者信息

Murudi-Manganye Nthuseni Sharon, Makhado Lufuno, Sehularo Leepile Alfred

机构信息

Department of Public Health, School of Health Sciences, University of Venda, Thohoyandou 0950, South Africa.

School of Nursing Science, Faculty of Health Sciences, North-West University, Potchefstroom 2531, South Africa.

出版信息

Clin Pract. 2023 Mar 9;13(2):410-421. doi: 10.3390/clinpract13020037.

Abstract

Integrated management of human immune deficiency virus (HIV) and non-communicable diseases (NCDs) in primary health care facilities remains a challenge. Despite research that has been conducted in South Africa, it is evident that in Limpopo Province there are slits in the implementation thereof. There is a need to develop a conceptual model to guide in strengthening the clinical competence of nurse-initiated management of antiretroviral therapy (NIMART)-trained nurses to implement the integrated management of HIV and NCDs to improve clinical outcomes of patients with the dual burden of diseases in Limpopo Province, South Africa. This study aimed to develop a conceptual model to strengthen the implementation of integrated management of HIV and NCDs amongst NIMART nurses to improve clinical outcomes of patients with the dual burden of communicable and non-communicable diseases in Limpopo Province, South Africa. An explanatory, sequential, mixed-methods research design was followed. Data were collected from patient records and the skills audit of 25 Primary Health Care (PHC) facilities and from 28 NIMART trained nurses. Donabedian's structure process outcome model and Miller's pyramid of clinical competence provided a foundation in the development of the conceptual model. The study revealed a need to develop a conceptual model to strengthen the implementation of integrated HIV and NCDs implementation in PHC, as evidenced by differences in the management of HIV and NCDs. Conclusion: The study findings were conceptualised to describe and develop a model needed to strengthen the implementation of integrated management of HIV and NCDs amongst NIMART nurses working in PHC facilities. The study was limited to Limpopo Province; the model must be implemented in conjunction with the available frameworks to achieve better clinical outcomes.

摘要

在初级卫生保健机构中,对人类免疫缺陷病毒(HIV)和非传染性疾病(NCDs)进行综合管理仍然是一项挑战。尽管南非已经开展了相关研究,但很明显,林波波省在这方面的实施存在漏洞。有必要开发一个概念模型,以指导加强接受抗逆转录病毒治疗护士初始管理培训(NIMART)的护士的临床能力,从而在南非林波波省实施HIV和NCDs的综合管理,以改善患有这两种疾病双重负担的患者的临床结局。本研究旨在开发一个概念模型,以加强NIMART护士对HIV和NCDs的综合管理实施,从而改善南非林波波省患有传染性和非传染性疾病双重负担的患者的临床结局。本研究采用了解释性、序贯性混合方法研究设计。数据收集自25个初级卫生保健(PHC)机构的患者记录和技能审计,以及28名接受NIMART培训的护士。多纳贝迪安的结构-过程-结果模型和米勒的临床能力金字塔为概念模型的开发提供了基础。研究表明,有必要开发一个概念模型来加强初级卫生保健中HIV和NCDs综合管理的实施,HIV和NCDs管理方面的差异证明了这一点。结论:本研究结果被概念化,以描述和开发一个加强在初级卫生保健机构工作的NIMART护士对HIV和NCDs综合管理实施所需的模型。本研究仅限于林波波省;该模型必须与现有框架结合实施,以实现更好的临床结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/502b/10037621/422df7a4d960/clinpract-13-00037-g001.jpg

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