为慢性病患儿实施“我的积极健康”对话工具：障碍与促进因素

Implementing the My Positive Health dialogue tool for children with a chronic condition: barriers and facilitators.

作者信息

de Jong-Witjes S, Berkelbach van der Sprenkel E E, Kars M C, Huber M, Nijhof S L, Nuboer R, Broekhuijsen-van Henten D M, Lasham C A, van Mil E G A H, van de Putte E M

机构信息

Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands.

Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.

出版信息

BMC Pediatr. 2025 Mar 5;25(1):168. doi: 10.1186/s12887-024-05258-0.

DOI:10.1186/s12887-024-05258-0

PMID:40045232

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11881396/

Abstract

BACKGROUND

The My Positive Health (MPH) dialogue tool for children was developed to aid children and teenagers in reflecting and communicating about their health from a broader perspective. This study investigates facilitators and barriers to implementation in pediatric care and assesses experiences of healthcare professionals (HCPs) and children regarding effectiveness.

METHODS

We conducted a mixed-methods study involving six Dutch pediatric outpatient clinics. Quantitative data on facilitators and barriers were obtained from 18 out of 20 participating HCPs (pediatricians, nurse practitioners and physician assistants) using the Measurement Instrument for Determinants of Innovations. Additionally, qualitative insights were gathered through semi-structured interviews with 17 HCPs and 30 children (8-18 years old) with chronic conditions.

RESULTS

Facilitators identified in both user and innovation domains included improved patient understanding and the tool's simplicity, while barriers involved organizational constraints and integration issues, for example limited resources and lack of organizational support. Participating HCPs highlighted the tool's role in fostering person-centered conversations, especially for children with chronic conditions. Children positively viewed the tool, noting its ability to enable deeper, personalized interactions with HCPs.

CONCLUSION

This study on the implementation of the MPH dialogue tool for children in pediatric care highlights its user-friendliness and relevance, alongside challenges like organizational constraints. Beneficial for person-centered care and children's active participation, the tool enhanced healthcare dialogues and empowered children in their health journey. However, HCPs faced integration challenges within existing practices. Addressing these barriers and providing organizational support are vital for effectively implementing the MPH dialogue tool and optimizing pediatric patient engagement and care quality.

摘要

背景

为帮助儿童和青少年从更广泛的角度思考和交流自身健康状况，开发了儿童“我的积极健康”（MPH）对话工具。本研究调查了该工具在儿科护理中实施的促进因素和障碍，并评估了医疗保健专业人员（HCPs）和儿童对其有效性的体验。

方法

我们开展了一项混合方法研究，涉及荷兰的六家儿科门诊诊所。使用创新决定因素测量工具，从20名参与研究的HCPs（儿科医生、执业护士和医师助理）中的18名获取了关于促进因素和障碍的定量数据。此外，通过对17名HCPs和30名患有慢性病的8至18岁儿童进行半结构化访谈，收集了定性见解。

结果

在用户和创新领域确定的促进因素包括提高患者理解度和工具的简易性，而障碍则涉及组织限制和整合问题，例如资源有限和缺乏组织支持。参与研究的HCPs强调了该工具在促进以患者为中心的对话方面的作用，特别是对于患有慢性病的儿童。儿童对该工具给予了积极评价，指出它能够与HCPs进行更深入、个性化的互动。

结论

这项关于儿童MPH对话工具在儿科护理中实施情况的研究突出了其用户友好性和相关性，以及诸如组织限制等挑战。该工具有利于以患者为中心的护理和儿童的积极参与，增强了医疗对话，并使儿童在健康之旅中更有自主权。然而，HCPs在现有实践中面临整合挑战。解决这些障碍并提供组织支持对于有效实施MPH对话工具以及优化儿科患者参与度和护理质量至关重要。