Univ. Grenoble Alpes, CNRS, VetAgro Sup, Grenoble INP, Grenoble, France.
Department of Physiotherapy University Grenoble Alpes, Grenoble, France.
PLoS One. 2023 Sep 1;18(9):e0291079. doi: 10.1371/journal.pone.0291079. eCollection 2023.
Contextual factor use by healthcare professionals has been studied mainly among nurses and physiotherapists. Preliminary results show that healthcare professionals use contextual factors without specifically labelling them as such. The main objective of this study was to evaluate knowledge and explore voluntary contextual factor use among various healthcare professions. The results aim to facilitate hypothesis-generation, to better position further research to explain and characterise contextual factor use. We conducted a web-based questionnaire cross-sectional observational study on a non-probabilistic convenience sample. Face and content validity were tested through cognitive interviews. Data were analysed descriptively. The target population was the main healthcare profession, or final year students, defined by the French public health law. The countries of distribution of the questionnaire were the French-speaking European countries. Among our 1236 participants, use of contextual factors was widespread. Those relating to the therapeutic relationship (e.g., communication) and patient characteristics (e.g., past experiences) were reportedly the most used. Meanwhile, contextual factors related to the healthcare providers' characteristics and their own beliefs were reported as less used. Despite high variability, respondents suggested contextual effects contribute to approximately half of the overall effect in healthcare and were perceived as more effective on children and elderly adults. Conceptual variations that exist in the literature are also present in the way healthcare providers consider contextual effects. Interestingly, there seems to be common ground between how physiotherapists, nurses and physicians use different contextual factors. Finally, in the present study we also observed that while there are similarities across usage, there is lack of both an epistemological and ethical consensus among healthcare providers with respect to contextual factors.
医疗保健专业人员对情境因素的使用主要在护士和物理治疗师中进行了研究。初步结果表明，医疗保健专业人员在使用情境因素时并未明确将其标记为情境因素。本研究的主要目的是评估知识并探索各种医疗保健专业人员自愿使用情境因素。研究结果旨在促进假设的产生，更好地定位进一步的研究，以解释和描述情境因素的使用。我们在非概率便利样本中进行了基于网络的问卷调查横断面观察研究。通过认知访谈测试了表面效度和内容效度。数据进行了描述性分析。目标人群是根据法国公共卫生法定义的主要医疗保健专业人员或最后一年的学生。问卷调查的分布国家是说法语的欧洲国家。在我们的 1236 名参与者中，广泛使用了情境因素。据报道，与治疗关系（例如，沟通）和患者特征（例如，过去的经历）相关的情境因素是最常用的。同时，与医疗保健提供者的特征及其自身信念相关的情境因素被报告为使用较少。尽管存在高度的可变性，但受访者认为情境效应约占医疗保健总效应的一半，并且对儿童和老年人的影响更大。文献中存在的概念差异也存在于医疗保健提供者对情境效应的看法中。有趣的是，物理治疗师、护士和医生使用不同的情境因素之间似乎存在共同点。最后，在本研究中，我们还观察到，尽管使用情况存在相似之处，但医疗保健提供者在情境因素方面缺乏认识论和伦理共识。
