OBJECTIVE: To identify the barriers and enablers of using the OQUA as perceived by ENT surgeons and patients and provide recommendations for an implementation strategy.
METHODS: Prospective and qualitative analysis was performed using focus groups and interviews with ENT professionals (n = 15) and patients (n = 25) with ear complaints of one tertiary referral hospital and two regional hospitals. Barriers and enablers were identified and classified by using the Capability-Opportunity-Motivation-Behavior model and the Theoretical Domains Framework. Suggestions for an implementation strategy will be made accordingly.
RESULTS: ENT professionals\' barriers included lack of knowledge and skills to use the OQUA, inadequate technological support and perceived time constraints during consultation, uncertainty about the clinical relevance and lack of feedback on the outcomes of the OQUA. Enablers included beneficial consequences of the OQUA for the professional, organization and science. Patients\' barriers included lack of knowledge about the objective and usefulness of the OQUA, perceived burden, difficulties in completing the questionnaire and insufficient feedback during consultation. Patient enablers included beliefs about beneficial consequences of the OQUA for the patient, health care and society. Suggested interventions involved education, training, environmental restructuring and incentivisation.
CONCLUSIONS: Based on the findings, we propose an implementation strategy should focus on education and training about the objective, outcomes and relevance of the OQUA, environmental restructuring regarding the optimal use of the OQUA, and incentivisation with feedback on the valuable outcomes of the OQUA for the patient, professional and healthcare. Future research is needed to determine the feasibility of the implementation strategy.
目的:确定耳鼻喉科外科医生和患者认为使用OQUA的障碍和促成因素,并为实施策略提供建议。
方法:使用焦点小组和对一家三级转诊医院和两家地区医院的耳鼻喉科专业人员(n=15)和患者(n=25)进行访谈,进行前瞻性和定性分析。通过使用能力-机会-动机-行为模型和理论域框架来识别和分类障碍和推动者。将相应地提出实施战略的建议。
结果:ENT专业人员的障碍包括缺乏使用OQUA的知识和技能,在咨询过程中,技术支持不足和感知的时间限制,对OQUA结果的临床相关性的不确定性和缺乏反馈。促进者包括OQUA对专业人士的有益后果,组织和科学。患者的障碍包括缺乏关于OQUA的客观和有用性的知识,感知负担,填写问卷有困难,咨询期间反馈不足。患者推动者包括关于OQUA对患者有益后果的信念,医疗保健和社会。建议的干预措施涉及教育,培训,环境重组和激励。
结论:根据调查结果,我们提出实施战略应侧重于目标的教育和培训,OQUA的结果和相关性,关于优化使用OQUA的环境重组,并通过对OQUA对患者的有价值结果的反馈来激励,专业和医疗保健。需要进一步的研究来确定实施策略的可行性。