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医疗保健专业人员对慢性病患者综合护理模式实施情况的看法。

Healthcare Professionals' Perspectives on the Implementation of the Integrated Care Models for Chronic Patients.

作者信息

Konstantinidis Nikolaos V, Talias Michael A

机构信息

Healthcare Management/Health Economics, Open University of Cyprus, Nicosia, CYP.

出版信息

Cureus. 2023 Jul 20;15(7):e42173. doi: 10.7759/cureus.42173. eCollection 2023 Jul.

Abstract

Objective This study aimed to assess the understanding, adoption, and barriers to implementing integrated care for chronic diseases among healthcare professionals in Greece. By gathering insights from healthcare professionals directly involved in the care of patients with chronic conditions, this study sought to identify areas for improvement and inform future policy and strategic initiatives to enhance the quality of care and patient outcomes in Greece. Specific objectives included assessing healthcare professionals' knowledge and understanding of integrated care concepts, principles, and components in chronic disease management and exploring healthcare professionals' experiences in providing or participating in integrated care activities for patients with chronic diseases. Methods This study employed a census-based survey design to assess healthcare professionals' understanding, adoption, and barriers to the implementation of integrated care for chronic diseases in the Greek healthcare system. The sampling technique has been used to ensure the representation of different healthcare professions and regions in Greece. The survey questionnaire was structured based on the internationally recognized Chronic Care Model Elements Survey, specifically tailored to capture insights on integrated care for chronic illnesses in Greece. Healthcare professionals from diverse settings, including primary healthcare centers, public and private hospitals, specialty clinics, rehabilitation centers, home-based care services, and private sector practitioners, were targeted to gather comprehensive perspectives. Both urban and rural areas were included to ensure a representative sample, enabling an understanding of integrated care implementation in Greece. Results A total of 246 responses from healthcare professionals in Greece were collected and analyzed. An applicability index was constructed to evaluate the suitability of the integrated care system in Greece, utilizing variables collected during the survey. The reliability of the index was assessed using Cronbach's Alpha coefficient, which demonstrated a high value of 0.940, indicating strong internal consistency and correlation among the questions related to integrated care. However, the data collected for Greece exhibited a departure from a normal distribution using the Shapiro-Wilk test, suggesting the presence of barriers to the implementation of integrated care within the Greek healthcare system. Conclusions The study revealed several obstacles to integrated care implementation, encompassing organizational and individual factors, such as financial constraints, cultural differences, and regulatory challenges. Tackling these barriers will require a collective approach and close collaboration among multiple stakeholders to create an enabling context for adopting integrated care. Possible strategies involve resource allocation, fostering communication and cooperation among healthcare providers, and revising regulatory frameworks to facilitate integrated care practices. In order to achieve the national objectives of improving public health, the survey increases the focus on evidence-based public health.

摘要

目的 本研究旨在评估希腊医疗保健专业人员对实施慢性病综合护理的理解、采用情况及障碍。通过收集直接参与慢性病患者护理的医疗保健专业人员的见解,本研究试图确定改进领域,并为未来的政策和战略举措提供信息,以提高希腊的护理质量和患者治疗效果。具体目标包括评估医疗保健专业人员对慢性病管理中综合护理概念、原则和组成部分的知识和理解,以及探索医疗保健专业人员在为慢性病患者提供或参与综合护理活动方面的经验。

方法 本研究采用基于普查的调查设计,以评估希腊医疗保健系统中医疗保健专业人员对实施慢性病综合护理的理解、采用情况及障碍。抽样技术用于确保希腊不同医疗保健专业和地区的代表性。调查问卷基于国际认可的慢性病护理模式要素调查构建,专门针对获取希腊慢性病综合护理的见解进行了调整。目标人群包括来自不同机构的医疗保健专业人员,如初级医疗保健中心、公立和私立医院、专科诊所、康复中心、居家护理服务机构以及私营部门从业者,以收集全面的观点。城乡地区均有纳入,以确保样本具有代表性,从而了解希腊综合护理的实施情况。

结果 共收集并分析了希腊医疗保健专业人员的246份回复。利用调查期间收集的变量构建了一个适用性指数,以评估希腊综合护理系统的适用性。使用克朗巴哈系数评估该指数的可靠性,结果显示其值高达0.940,表明与综合护理相关的问题之间具有很强的内部一致性和相关性。然而,使用夏皮罗-威尔克检验对希腊收集的数据进行分析时发现其偏离正态分布,这表明希腊医疗保健系统在实施综合护理方面存在障碍。

结论 该研究揭示了综合护理实施中的几个障碍,包括组织和个人因素,如资金限制、文化差异和监管挑战。应对这些障碍需要多方利益相关者采取集体方法并密切合作,以创造采用综合护理的有利环境。可能的策略包括资源分配、促进医疗保健提供者之间的沟通与合作,以及修订监管框架以促进综合护理实践。为了实现改善公众健康的国家目标,该调查增加了对循证公共卫生的关注。

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