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从教育者到促进者:医疗保健专业人员在行为科学指导下实施 1 型糖尿病结构化教育计划(DAFNEplus)的经验和观点。

From educator to facilitator: Healthcare professionals' experiences of, and views about, delivering a type 1 diabetes structured education programme (DAFNEplus ) informed by behavioural science.

机构信息

Usher Institute, Medical School, University of Edinburgh, Edinburgh, UK.

SCHARR, School of Medicine and Population Health, University of Sheffield, Sheffield, UK.

出版信息

Diabet Med. 2024 Aug;41(8):e15375. doi: 10.1111/dme.15375. Epub 2024 Jun 4.

Abstract

AIMS

The DAFNEplus programme incorporates behaviour change techniques into a modified educational intervention and was developed to help address the glycaemic drift observed amongst graduates of standard DAFNE programmes. As the programme's success will be contingent on staff buy-in, we explored healthcare professionals' experiences of, and views about, delivering DAFNEplus during a clinical trial to help inform decision making about rollout post-trial.

METHODS

We interviewed n = 18 nurses and dieticians who delivered DAFNEplus during the trial. Data were analysed thematically.

RESULTS

While many shared initial reservations, all described how their experiences of DAFNEplus programme delivery had had a positive, transformative impact upon their perceptions and working practices. This transformation was enabled by initial training and supervision sessions, the confidence gained from using scripts to support novel programme content delivery, and experiences of delivering the programme and observing DAFNEplus principles being well received by, and having a positive impact on, attendees. Due to these positive experiences, interviewees described a strongly felt ethical mandate to use some DAFNEplus techniques and curriculum content in routine clinical care. While being supportive of a national rollout, they anticipated a variety of attitudinal and logistical (e.g. workload) challenges.

CONCLUSIONS

This study provides a vital dimension to the evaluation of the DAFNEplus programme. Interviewees found the intervention to be acceptable and expressed high levels of buy-in. As well as offering potential endorsement for a national rollout, our findings offer insights which could help inform development and rollout of future behaviour change interventions to support diabetes self-management.

摘要

目的

DAFNEplus 计划将行为改变技术纳入改良的教育干预措施中,旨在帮助解决标准 DAFNE 计划毕业生中观察到的血糖漂移问题。由于该计划的成功将取决于员工的认同,我们在临床试验中探讨了医疗保健专业人员提供 DAFNEplus 的经验和看法,以帮助为试验后推出提供决策依据。

方法

我们采访了在试验中提供 DAFNEplus 的 18 名护士和营养师。数据进行了主题分析。

结果

尽管许多人最初持保留意见,但所有人都描述了他们提供 DAFNEplus 计划的经验如何对他们的看法和工作实践产生了积极的变革性影响。这种转变是通过初始培训和监督会议、使用脚本支持新的计划内容交付所获得的信心,以及提供计划和观察 DAFNEplus 原则的经验得到参与者的好评和积极影响而实现的。由于这些积极的经验,受访者强烈感受到在常规临床护理中使用一些 DAFNEplus 技术和课程内容的道德责任。他们虽然支持全国推广,但预计会面临各种态度和后勤(如工作量)挑战。

结论

本研究为 DAFNEplus 计划的评估提供了重要的维度。受访者认为该干预措施是可以接受的,并表示高度认同。除了为全国推广提供潜在支持外,我们的研究结果还提供了见解,可以帮助为支持糖尿病自我管理的未来行为改变干预措施的开发和推广提供信息。

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