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狼疮决策辅助工具的临床人员态度和基线实施结果。

Clinic personnel attitudes and baseline implementation outcomes of a lupus decision aid.

机构信息

Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, USA.

Department of Healthcare Administration & Policy, School of Health Sciences, University of New Haven, West Haven, CT, USA.

出版信息

Psychol Health Med. 2024 Dec;29(10):1835-1847. doi: 10.1080/13548506.2024.2407448. Epub 2024 Oct 15.

Abstract

To examine the association between clinical personnel's general attitudes towards new interventions and implementation outcomes related to an evidence-based individualized, culturally tailored, computerized decision aid (DA) for the management of lupus. To assess attitudes, the validated Evidence-Based Practice Attitudes Scale (EBPAS) survey was emailed to personnel in 15 rheumatology clinics across the U.S. The survey also included questions related to three validated implementation outcomes: lupus DA acceptability, appropriateness and feasibility. The baseline round of the survey was fielded from August 2019 to January 2020 and yielded a 56.8% response rate ( = 76 respondents). We also collected organizational characteristics from each clinic and personnel-level control variables. Overall, respondents reported modest levels of lupus DA acceptability, appropriateness and feasibility (3.54, 3.45 and 3.40, respectively, on a scale of 1-5). Multilevel regression analyses demonstrated statistically significant positive relationships between a respondent's openness to new practices/interventions and perceived lupus DA acceptability (β = 0.31,  < .01) and feasibility (β = 0.28,  < .05). Divergence (a respondent's perceived difference between current and new practices) was not associated with clinic personnel perceptions of the DA. These findings suggest that understanding clinic personnel general attitudes toward new interventions is an important precursor to implementing evidence-based practices and may provide important diagnostic information about places to intervene in preparation for implementation and improving shared decision-making with patients.

摘要

目的

探讨临床人员对新干预措施的总体态度与实施结果之间的关系,这些实施结果与基于证据的个体化、文化适宜性、计算机化决策辅助(DA)在狼疮管理中的应用有关。为了评估态度,向美国 15 个风湿病诊所的工作人员发送了经过验证的循证实践态度量表(EBPAS)调查。该调查还包括与三个经过验证的实施结果相关的问题:狼疮 DA 的可接受性、适宜性和可行性。调查的基线轮于 2019 年 8 月至 2020 年 1 月进行,回复率为 56.8%( = 76 名受访者)。我们还从每个诊所收集了组织特征和人员水平的控制变量。总的来说,受访者报告了狼疮 DA 可接受性、适宜性和可行性的中等水平(分别为 1-5 分制的 3.54、3.45 和 3.40)。多水平回归分析表明,受访者对新实践/干预措施的开放程度与感知到的狼疮 DA 可接受性(β = 0.31,  < .01)和可行性(β = 0.28,  < .05)之间存在统计学上显著的正相关关系。分歧(受访者认为当前实践与新实践之间的差异)与诊所人员对 DA 的看法无关。这些发现表明,了解临床人员对新干预措施的总体态度是实施基于证据的实践的重要前提,并且可能为实施前改善与患者的共同决策提供有关干预地点的重要诊断信息。

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