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利益相关者确定的在英国炎症性肠病服务中实施超声的障碍和促进因素:定性访谈研究。

Stakeholder-identified barriers and enablers to ultrasound implementation in inflammatory bowel disease services in the UK: a qualitative interview study.

机构信息

School of Medicine, University of Nottingham, Nottingham, UK

Division of Primary Care, University of Nottingham, Nottingham, UK.

出版信息

BMJ Open. 2023 Jun 22;13(6):e067528. doi: 10.1136/bmjopen-2022-067528.

Abstract

OBJECTIVES

The study sought to explore and better understand the perceptions and experiences of stakeholders in relation to the use of ultrasound for the assessment of inflammatory bowel disease (IBD) in adults in the UK.

DESIGN

A qualitative semistructured interview study, using template analysis and normalisation process theory, was undertaken.

SETTING

Interviews were conducted using virtual meeting software.

RESULTS

Fourteen participants were enrolled between 2nd of June 2021 and 6th of September 2021. Participants were from the following roles: medical gastroenterology and radiology doctors, IBD nurse specialists, patients living with IBD, healthcare service managers. Participants reported that perceived barriers included reliance on established imaging and care pathways, reluctance to change, lack of trust in ultrasound in relation to perceived lack of precision and the initial financial and time outlay in establishing an ultrasound service. Participants were enthusiastic for the uptake of ultrasound and discussed enablers to ultrasound uptake including the benefits to patients in terms of reduction in waiting times and earlier diagnosis and treatment allocation, reduced number of hospital appointments and patients having better understanding of their health.

CONCLUSION

There are perceived barriers to achieving implementation of ultrasound. There is scant literature to effectively assess these reported barriers. Therefore, there is further research required in the areas of the impact of the use of ultrasound for the assessment of IBD in the UK.

摘要

目的

本研究旨在探讨和更好地理解利益相关者对英国成人炎症性肠病(IBD)评估中使用超声的看法和经验。

设计

采用半结构化访谈的定性研究,使用模板分析和规范进程理论。

设置

使用虚拟会议软件进行访谈。

结果

2021 年 6 月 2 日至 9 月 6 日期间,共纳入 14 名参与者。参与者来自以下角色:医学胃肠病学和放射学医生、IBD 护理专家、IBD 患者、医疗保健服务经理。参与者报告称,感知到的障碍包括对既定影像学和护理途径的依赖、不愿改变、对超声缺乏信任,认为其缺乏准确性,以及在建立超声服务方面最初的财务和时间投入。参与者对超声的采用充满热情,并讨论了超声采用的促进因素,包括减少等待时间和更早诊断和治疗分配、减少医院预约次数以及患者更好地了解自己的健康状况等方面对患者的益处。

结论

实现超声应用存在感知障碍。几乎没有文献能够有效地评估这些报告的障碍。因此,需要在英国使用超声评估 IBD 的影响领域进一步开展研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/978b/10314467/c483cba358d3/bmjopen-2022-067528f01.jpg

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