PDF(Pubmed)
Abstract：
OBJECTIVE: Service referrals are required for cancer survivors to access specialist dietary and exercise support. Many system-level factors influence referral practices within the healthcare system. Hence, the aim of this study was to identify system-level factors and their interconnectedness, as well as strategies for optimising dietary and exercise referral practices in Australia.
METHODS: A full-day workshop involving national multidisciplinary key stakeholders explored system-level factors impacting dietary and exercise referral practices. Facilitated group discussions using the nominal group technique identified barriers and facilitators to referral practices based on the six World Health Organisation (WHO) building blocks. The systems-thinking approach generated six cognitive maps, each representing a building block. A causal loop diagram was developed to visualise factors that influence referral practices. Additionally, each group identified their top five strategies by leveraging facilitators and addressing barriers relevant to their WHO building block.
RESULTS: Twenty-seven stakeholders participated in the workshop, including consumers (n = 2), cancer specialists (n = 4), nursing (n = 6) and allied health professionals (n = 10), and researchers, representatives of peak bodies, not-for-profit organisations, and government agencies (n = 5). Common system-level factors impacting on referral practices included funding, accessibility, knowledge and education, workforce capacity, and infrastructure. Fifteen system-level strategies were identified to improve referral practices.
CONCLUSIONS: This study identified system-level factors and strategies that can be applied to policy planning and practice in Australia.
METHODS: A full-day workshop involving national multidisciplinary key stakeholders explored system-level factors impacting dietary and exercise referral practices. Facilitated group discussions using the nominal group technique identified barriers and facilitators to referral practices based on the six World Health Organisation (WHO) building blocks. The systems-thinking approach generated six cognitive maps, each representing a building block. A causal loop diagram was developed to visualise factors that influence referral practices. Additionally, each group identified their top five strategies by leveraging facilitators and addressing barriers relevant to their WHO building block.
RESULTS: Twenty-seven stakeholders participated in the workshop, including consumers (n = 2), cancer specialists (n = 4), nursing (n = 6) and allied health professionals (n = 10), and researchers, representatives of peak bodies, not-for-profit organisations, and government agencies (n = 5). Common system-level factors impacting on referral practices included funding, accessibility, knowledge and education, workforce capacity, and infrastructure. Fifteen system-level strategies were identified to improve referral practices.
CONCLUSIONS: This study identified system-level factors and strategies that can be applied to policy planning and practice in Australia.
摘要：
目的：癌症幸存者需要服务转诊才能获得专科饮食和运动支持。许多系统级因素会影响医疗保健系统内的转诊实践。因此，本研究的目的是确定系统层面的因素及其相互联系，以及优化澳大利亚饮食和运动转诊实践的策略。
方法：由国家多学科关键利益相关者参加的全天研讨会探讨了影响饮食和运动转诊实践的系统层面因素。使用名义小组技术促进小组讨论，根据世界卫生组织（WHO）的六个组成部分，确定了转诊实践的障碍和促进者。系统思维方法生成了六个认知图，每个代表一个建筑块。开发了因果循环图，以可视化影响转诊实践的因素。此外,每个小组通过利用促进者和解决与其世卫组织构建模块相关的障碍，确定了他们的五大战略。
结果：27个利益相关者参加了研讨会，包括消费者(n=2)，癌症专家（n=4），护理（n=6）和专职医疗专业人员（n=10），和研究人员，高峰机构的代表，非营利组织，和政府机构(n=5)。影响转介做法的共同系统一级因素包括供资、可访问性,知识和教育，劳动力能力，和基础设施。确定了15项系统级战略，以改善转诊做法。
结论：本研究确定了可应用于澳大利亚政策规划和实践的系统级因素和策略。
方法：由国家多学科关键利益相关者参加的全天研讨会探讨了影响饮食和运动转诊实践的系统层面因素。使用名义小组技术促进小组讨论，根据世界卫生组织（WHO）的六个组成部分，确定了转诊实践的障碍和促进者。系统思维方法生成了六个认知图，每个代表一个建筑块。开发了因果循环图，以可视化影响转诊实践的因素。此外,每个小组通过利用促进者和解决与其世卫组织构建模块相关的障碍，确定了他们的五大战略。
结果：27个利益相关者参加了研讨会，包括消费者(n=2)，癌症专家（n=4），护理（n=6）和专职医疗专业人员（n=10），和研究人员，高峰机构的代表，非营利组织，和政府机构(n=5)。影响转介做法的共同系统一级因素包括供资、可访问性,知识和教育，劳动力能力，和基础设施。确定了15项系统级战略，以改善转诊做法。
结论：本研究确定了可应用于澳大利亚政策规划和实践的系统级因素和策略。
