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人道主义背景下非传染性疾病管理的任务分担:中低收入国家(LMIC)的一种创新方法

Task sharing for the management of non-communicable diseases in a humanitarian setting: An innovative approach in a low-middle income country (LMIC).

作者信息

Doumit Myrna, Masri Sahar, Ciglenecki Iza, Albela Manuel

机构信息

American University of Beirut, Hariri School of Nursing, Beirut, Lebanon.

Médecins sans Frontières Operational Center of Geneva (OCG), Beirut, Lebanon.

出版信息

Public Health Pract (Oxf). 2025 Jul 25;10:100643. doi: 10.1016/j.puhip.2025.100643. eCollection 2025 Dec.

Abstract

UNLABELLED

The World Health Organization (WHO) defines task shifting as the balanced reallocation of tasks from highly experienced professionals to those with more limited training, thus allowing the existing human resources to be used more efficiently. In Lebanon, there is no documented evidence yet of task sharing between physicians and nurses in the usual primary healthcare setting, let alone for Non-Communicable Disease (NCD) management.

OBJECTIVE

This study aims to explore the experiences of healthcare providers and patients regarding task sharing.

STUDY DESIGN

This study employed a qualitative descriptive design, utilizing a cross-sectional approach.

METHOD

Qualitative data collection started in April-May 2022. Data collection was conducted with three focus groups: nurses (n = 9), patients (n = 11), and physicians (n = 5) from two clinics in two different rural areas, using purposeful sampling. A thematic analysis method, as described by Braun and Clarke, was used to guide the analysis.

RESULTS

This study yielded four themes: An innovative approach to care, A prevailing culture of trust and collaboration, a Synergistic Outcome, and A Call for Improvement.

CONCLUSION

This study has identified an innovative approach to care, as demonstrated by the practices performed at the two clinics. Task shifting is a means of ensuring nurses' satisfaction. Therefore, it may positively impact retention at a time when we are witnessing an unprecedented migration of nurses from low- and middle-income countries (LMICs) to high-income countries (HICs). Interprofessional education needs to be reinforced at the undergraduate level to enhance collaboration among health care workers after graduation. At the policy level, considerable work is necessary to ensure that all stakeholders' voices are represented at the decision-making table and heard.

摘要

未标注

世界卫生组织(WHO)将任务转移定义为将任务从经验丰富的专业人员平衡地重新分配给培训较少的人员,从而使现有人力资源得到更有效的利用。在黎巴嫩,尚无文件证明在常规初级医疗保健环境中医生和护士之间存在任务分担情况,更不用说在非传染性疾病(NCD)管理方面了。

目的

本研究旨在探索医疗服务提供者和患者对任务分担的体验。

研究设计

本研究采用定性描述性设计,采用横断面研究方法。

方法

定性数据收集于2022年4月至5月开始。通过立意抽样,对来自两个不同农村地区的两家诊所的三个焦点小组进行了数据收集:护士(n = 9)、患者(n = 11)和医生(n = 5)。采用布劳恩和克拉克描述的主题分析方法指导分析。

结果

本研究得出四个主题:创新的护理方法、普遍存在的信任与合作文化、协同结果以及改进的呼声。

结论

本研究确定了一种创新的护理方法,如两家诊所的实践所示。任务转移是确保护士满意度的一种方式。因此,在我们目睹护士前所未有的从低收入和中等收入国家(LMICs)向高收入国家(HICs)迁移之际,它可能对留用产生积极影响。本科阶段需要加强跨专业教育,以增强医护人员毕业后的合作。在政策层面,有必要开展大量工作,以确保所有利益相关者的声音在决策桌上得到体现并被听取。

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