关键词: care manager collaborative care implementation planning process implementation strategies integrated care primary care nurse

来  源:   DOI:10.5334/ijic.5556   PDF(Pubmed)

Abstract:
UNASSIGNED: Primary care nurses are well-suited to provide care management for common mental disorders, but their practices depend on context. Various strategies can be considered to improve the adoption of nursing care manager activities, but data from implementation studies rarely address strategy formulation.
UNASSIGNED: To analyze the influence of contextual factors on strategy formulation to improve the adoption of care manager activities by primary care nurses.
UNASSIGNED: A qualitative multiple case study in three primary care clinics was carried out. Data were collected through individual interviews (n = 32) and observations (n = 7), working group meetings, and relevant documents. Thematic analysis was conducted.
UNASSIGNED: Contextual factors influenced strategy formulation through organizational readiness for change, which resulted from tension for change and perceived organizational ability to implement change. Tension for change was generated through the perceived gap between patient needs and service availability, perceived compatibility with the nurses work environment, and their assessment of their capacity to perform care manager activities or acquire the necessary skills.
UNASSIGNED: Future studies should give sufficient attention to implementation strategy formulation and consider the dynamic role of organizational readiness for change when facilitating the adoption of evidence-based practices for common mental disorders in primary care.
摘要:
初级护理护士非常适合为常见的精神障碍提供护理管理,但是他们的做法取决于上下文。可以考虑各种策略来改善护理经理活动的采用,但实施研究的数据很少涉及战略制定。
分析情境因素对策略制定的影响,以改善初级保健护士对护理经理活动的采用。
在三个初级保健诊所中进行了定性的多案例研究。通过个人访谈(n=32)和观察(n=7)收集数据,工作组会议,和相关文件。进行了专题分析。
情境因素通过组织对变革的准备程度影响战略制定,这是由于变革的张力和感知的组织实施变革的能力。变化的张力是通过患者需求和服务可用性之间的差距而产生的,与护士工作环境的感知兼容性,以及他们对执行护理经理活动或获得必要技能的能力的评估。
未来的研究应充分关注实施策略的制定,并在促进对初级保健中常见精神障碍采用循证实践时考虑组织变革准备的动态作用。
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