PDF(Pubmed)
Abstract：
BACKGROUND: Neonatal jaundice is a common condition that can lead to brain damage and disabilities when severe cases go undetected. Low- and middle-income countries often lack accurate methods for detecting neonatal jaundice and rely on visual assessment, resulting in a higher incidence of adverse consequences. Picterus Jaundice Pro (Picterus JP), an easy-to-use and affordable smartphone-based screening device for the condition, has demonstrated higher accuracy than visual assessment in Norwegian, Philippine and Mexican newborns. This study aimed to identify the barriers and facilitators to implementing Picterus JP in public health services in low-income settings in Mexico by exploring the current process of neonatal jaundice detection and stakeholders\' perspectives in that context.
METHODS: Qualitative data collection techniques, including one focus group, 15 semi-structured interviews and four observations, were employed in urban and rural health facilities in Oaxaca, Mexico. The participants included medical doctors, nurses and health administrators. The data were analysed by thematic analysis guided by the Consolidated Framework for Implementation Research.
RESULTS: The analysis yielded four main themes: (I) the current state of neonatal care and NNJ detection, (II) the needs and desires for enhancing NNJ detection, (III) the barriers and facilitators to implementing Picterus JP in the health system and (IV) HCWs\' expectations of Picterus JP. The findings identify deficiencies in the current neonatal jaundice detection process and the participants\' desire for a more accurate method. Picterus JP was perceived as easy to use, useful and compatible with the work routine, but barriers to adoption were identified, including internet deficiencies and costs.
CONCLUSIONS: The introduction of Picterus JP as a supporting tool to screen for neonatal jaundice is promising but contextual barriers in the setting must be addressed for successful implementation. There is also an opportunity to optimise visual assessment to improve detection of neonatal jaundice.
METHODS: Qualitative data collection techniques, including one focus group, 15 semi-structured interviews and four observations, were employed in urban and rural health facilities in Oaxaca, Mexico. The participants included medical doctors, nurses and health administrators. The data were analysed by thematic analysis guided by the Consolidated Framework for Implementation Research.
RESULTS: The analysis yielded four main themes: (I) the current state of neonatal care and NNJ detection, (II) the needs and desires for enhancing NNJ detection, (III) the barriers and facilitators to implementing Picterus JP in the health system and (IV) HCWs\' expectations of Picterus JP. The findings identify deficiencies in the current neonatal jaundice detection process and the participants\' desire for a more accurate method. Picterus JP was perceived as easy to use, useful and compatible with the work routine, but barriers to adoption were identified, including internet deficiencies and costs.
CONCLUSIONS: The introduction of Picterus JP as a supporting tool to screen for neonatal jaundice is promising but contextual barriers in the setting must be addressed for successful implementation. There is also an opportunity to optimise visual assessment to improve detection of neonatal jaundice.
摘要：
背景：新生儿黄疸是一种常见病，当严重病例未被发现时，可导致脑损伤和残疾。低收入和中等收入国家往往缺乏检测新生儿黄疸的准确方法，依靠视觉评估，导致不良后果的发生率较高。PicterusJaundicePro（PicterusJP），一种易于使用且价格合理的基于智能手机的疾病筛查设备，在挪威已经证明了比视觉评估更高的准确性，菲律宾和墨西哥新生儿。这项研究旨在通过探索新生儿黄疸检测的当前过程和利益相关者的观点，确定在墨西哥低收入环境中在公共卫生服务中实施PicterusJP的障碍和促进者。
方法：定性数据收集技术，包括一个焦点小组，15次半结构化访谈和4次观察，受雇于瓦哈卡的城乡医疗机构，墨西哥。参与者包括医生，护士和卫生管理员。在执行研究综合框架的指导下，通过专题分析对数据进行了分析。
结果：分析产生了四个主要主题：（I）新生儿护理和NNJ检测的现状，(二)加强NNJ检测的需求和愿望，（III）在卫生系统中实施PicterusJP的障碍和促进者，以及（IV）HCWs对PicterusJP的期望。研究结果发现了当前新生儿黄疸检测过程中的缺陷，以及参与者对更准确方法的渴望。PicterusJP被认为易于使用，有用且与工作例程兼容，但是发现了收养的障碍，包括互联网缺陷和成本。
结论：引入PicterusJP作为筛查新生儿黄疸的支持工具是有希望的，但必须解决背景障碍才能成功实施。还有机会优化视觉评估以改善新生儿黄疸的检测。
方法：定性数据收集技术，包括一个焦点小组，15次半结构化访谈和4次观察，受雇于瓦哈卡的城乡医疗机构，墨西哥。参与者包括医生，护士和卫生管理员。在执行研究综合框架的指导下，通过专题分析对数据进行了分析。
结果：分析产生了四个主要主题：（I）新生儿护理和NNJ检测的现状，(二)加强NNJ检测的需求和愿望，（III）在卫生系统中实施PicterusJP的障碍和促进者，以及（IV）HCWs对PicterusJP的期望。研究结果发现了当前新生儿黄疸检测过程中的缺陷，以及参与者对更准确方法的渴望。PicterusJP被认为易于使用，有用且与工作例程兼容，但是发现了收养的障碍，包括互联网缺陷和成本。
结论：引入PicterusJP作为筛查新生儿黄疸的支持工具是有希望的，但必须解决背景障碍才能成功实施。还有机会优化视觉评估以改善新生儿黄疸的检测。
