Webber Ann L, Toomey Melinda, Keay Lisa, Dai Shuan, Gole Glen A, Newcomb Dana, McKinlay Lynne
School of Optometry and Vision Science, Queensland University of Queensland, Brisbane, Queensland, Australia.
School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia.
Ophthalmic Physiol Opt. 2024 Jan;44(1):52-70. doi: 10.1111/opo.13246. Epub 2023 Nov 27.
The Queensland Children's Hospital Paediatric Optometry Alignment Program commenced with a pilot phase to assess its feasibility, effectiveness and acceptability. This study identified the barriers that hinder effective interprofessional collaboration and the facilitators that contribute to its success, and assessed changes in optometrists' satisfaction since the pilot phase of the collaborative care programme.
Qualitative deductive and inductive content analysis was applied to open-ended free-text survey responses collected in 2018 from the optometrists involved in the Program's pilot phase. The responses were coded using the Theoretical Domains Framework (TDF) to categorise barriers and facilitators into key themes. Key behavioural determinants were mapped to the COM-B (Capability, Opportunity, Motivation-Behaviour) elements of the Behaviour Change Wheel model to identify intervention strategies. Intervention recommendations were derived from behaviour change mapping and compared with programme quality improvement initiatives. A cross-sectional explanatory survey informed by the TDF was conducted within the current 2023 cohort, and a longitudinal comparative analysis was carried out using data from the 2018 survey.
Among the 97 surveys distributed in 2018, 44 respondents participated; from this group, 38 individuals contributed a total of 200 free-text responses. Facilitators (240 comments) outnumbered barriers (65 comments). Key facilitators were accessible and timely care, professional development, confidence and positive outcome beliefs. Barriers included communication, information handover, credibility, relationships and skill gaps. Optometrists actively engaged in the programme in 2023 reported heightened satisfaction with their involvement, increased confidence and greater engagement in paediatric eyecare delivery. However, challenges in clinical information transfer persist.
The interprofessional collaborative model of paediatric eyecare has contributed efficiencies within the health system by building paediatric care capacity in the community, fostering professional credibility and promoting interdisciplinary trust. Insights gained should prove valuable for other paediatric eyecare services exploring hospital-to-community care models.
昆士兰儿童医院儿科验光协作项目始于试点阶段，以评估其可行性、有效性和可接受性。本研究确定了阻碍有效跨专业协作的障碍以及促成协作成功的促进因素，并评估了自协作护理项目试点阶段以来验光师满意度的变化。
对2018年参与该项目试点阶段的验光师收集的开放式自由文本调查回复进行定性演绎和归纳内容分析。使用理论领域框架（TDF）对回复进行编码，将障碍和促进因素归类为关键主题。将关键行为决定因素映射到行为改变轮模型的COM-B（能力、机会、动机-行为）要素，以确定干预策略。干预建议来自行为改变映射，并与项目质量改进举措进行比较。在2023年的队列中进行了一项基于TDF的横断面解释性调查，并使用2018年调查的数据进行了纵向比较分析。
2018年分发的97份调查问卷中，有44名受访者参与；在这一组中，38人共提供了200条自由文本回复。促进因素（240条评论）多于障碍因素（65条评论）。关键促进因素包括可及且及时的护理、专业发展、信心和积极结果信念。障碍包括沟通、信息交接、可信度、关系和技能差距。2023年积极参与该项目的验光师表示，他们对参与的满意度提高、信心增强，并且在儿科眼保健服务中的参与度更高。然而，临床信息传递方面的挑战依然存在。
儿科眼保健的跨专业协作模式通过在社区建立儿科护理能力、培养专业可信度和促进跨学科信任，提高了卫生系统的效率。所获得的见解对于其他探索从医院到社区护理模式的儿科眼保健服务应该是有价值的。
