Duke Global Neurosurgery and Neurology, Durham, NC, United States of America.
Duke Global Health Institute, Durham, NC, United States of America.
PLoS One. 2024 Jun 24;19(6):e0305382. doi: 10.1371/journal.pone.0305382. eCollection 2024.
Uganda has a high demand for neurosurgical and neurological care. 78% of the over 50 million population reside in rural and remote communities where access to neurosurgical and neurological services is lacking. This study aimed to determine the feasibility, appropriateness, and usability of mobile neuro clinics (MNCs) in providing neurological care to rural and remote Ugandan populations.
Neurosurgery, neurology, and mobile health clinic providers participated in an education and interview session to assess the feasibility, appropriateness, and usability of the MNC intervention. A qualitative analysis of the interview responses using the constructs in the updated Consolidated Framework for Implementation Research was performed. Providers' opinions were weighted using average sentiment scores on a novel sentiment-weighted scale adapted from the CFIR. A stakeholder analysis was also performed to assess the power and interest of the actors described by the participants.
Twenty-one healthcare providers completed the study. Participants discussed the potential benefits and concerns of MNCs as well as potential barriers and critical incidents that could jeopardize the intervention. Of the five CFIR domains evaluated, variables in the implementation process domain showed the highest average sentiment scores, followed by the implementation climate constructs, inner setting, innovation, and outer setting domains. Furthermore, many interested stakeholders were identified with diverse roles and responsibilities for implementing MNCs. These findings demonstrate that MNC innovation is feasible, appropriate, and usable.
The findings of this study support the feasibility, appropriateness, and usability of MNCs in Uganda. However, integration of this innovation requires careful planning and stakeholder engagement at all levels to ensure the best possible outcomes.
乌干达对神经外科学和神经科护理的需求很高。超过 5000 万人口中,有 78%居住在农村和偏远社区,那里缺乏神经外科学和神经科服务。本研究旨在确定移动神经诊所(MNC)在为乌干达农村和偏远地区人群提供神经科护理方面的可行性、适宜性和可用性。
神经外科、神经科和移动医疗诊所的提供者参加了一个教育和访谈会议,以评估 MNC 干预的可行性、适宜性和可用性。使用更新的实施研究综合框架中的结构对访谈回复进行定性分析。使用从 CFIR 改编的新型情感加权量表,对提供者的意见进行加权,以平均情感得分来表示。还进行了利益相关者分析,以评估参与者所描述的行为者的权力和利益。
21 名医疗保健提供者完成了这项研究。参与者讨论了 MNC 的潜在益处和关注点,以及可能危及干预的潜在障碍和关键事件。在评估的五个 CFIR 领域中,实施过程领域的变量显示出最高的平均情感得分,其次是实施气候结构、内部环境、创新和外部环境领域。此外,还确定了许多感兴趣的利益相关者,他们在实施 MNC 方面具有不同的角色和责任。这些发现表明,MNC 创新具有可行性、适宜性和可用性。
本研究的结果支持 MNC 在乌干达的可行性、适宜性和可用性。然而,要整合这一创新,需要在各个层面精心规划和利益相关者参与,以确保取得最佳成果。