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  • 文章类型: Journal Article
    背景:父母和学校护士之间的合作对于学校有效的医疗保健很重要。这项研究的重点是学校护士的胜任力,包括他们在糖尿病护理方面的知识和自我效能,并调查了这些因素,随着工作量,影响学校的医疗保健伙伴关系。然而,目前尚不清楚学校护士对糖尿病护理的知识和自我效能,以及他们的工作量,影响有关1型糖尿病儿童的学校医疗保健伙伴关系。
    目的:本研究旨在探讨学校护士自我效能感的影响,知识,态度,以及与学校1型糖尿病儿童父母的医疗保健合作关系中的角色超负荷。
    方法:横截面,描述性设计。
    方法:2023年12月至2024年1月在韩国,142名中小学护士参加了这项研究。
    方法:学校医疗保健伙伴关系,糖尿病教育中的自我效能感,对1型糖尿病学校医疗保健的知识和态度,并在分析中使用了角色过载量表。数据采用多元回归分析。
    结果:对1型糖尿病的学校医疗保健知识(β=0.34,p<.001)及其态度(β=0.29p=.001),以及当前就业学校的年级水平(β=-0.15,p=0.039)是学校医疗保健伙伴关系的预测因素。这三个变量解释了学校医疗保健伙伴关系总方差的30.3%(F=21.44,p<.001)。
    结论:学校护理知识和对1型糖尿病的态度被确定为学校护士学校护理伙伴关系的因素。因此,应制定加强学校护士能力的干预措施,以改善学校医疗保健伙伴关系。
    BACKGROUND: Collaboration between parents and school nurses is important for effective healthcare in schools. This study focuses on the competency of school nurses, which encompasses their knowledge and self-efficacy in diabetes care, and investigates how these factors, along with workload, influence healthcare partnerships in schools. However, it is unknown whether school nurses\' knowledge and self-efficacy about diabetes care, as well as their workload, affect school healthcare partnerships concerning children with type 1 diabetes.
    OBJECTIVE: This study aimed to investigate the impact of school nurses\' self-efficacy, knowledge, attitude, and role overload on healthcare partnerships with parents of children with type 1 diabetes in schools.
    METHODS: A cross-sectional, descriptive design.
    METHODS: Between December 2023 and January 2024 in South Korea, 142 elementary- and middle-school nurses participated in this study.
    METHODS: School healthcare partnership, self-efficacy in diabetes education, knowledge of and attitude toward school healthcare for type 1 diabetes, and the role-overload scale were utilized in the analysis. Data were analyzed using multiple regression.
    RESULTS: Knowledge of school healthcare (β = 0.34, p < .001) and attitude toward it (β = 0.29 p = .001) for type 1 diabetes, as well as the grade level of the current employing school (β = -0.15, p = .039) were predictors of school healthcare partnerships. These three variables explained 30.3 % of the total variance in school healthcare partnerships (F = 21.44, p < .001).
    CONCLUSIONS: Knowledge of school healthcare and attitudes toward it for type 1 diabetes were identified as factors in school nurses\' school healthcare partnerships. Therefore, interventions to strengthen school nurses\' competencies should be developed to improve school healthcare partnerships.
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  • 文章类型: Journal Article
    在英国,使用过的残疾设备的盈余造成了浪费,而在低收入和中等收入国家(LMICs),缺乏获得残疾设备的机会是需要解决的两个问题。为了解决这些问题,英国慈善机构翻新并将使用过的残疾设备重新分配给LMIC。迄今为止,关于LMICs如何从英国组织获得多余的残疾设备的数据很少。这项研究旨在整理和绘制设备从英国翻新和重新分配给LMIC的过程,并确定影响伙伴关系发展和可持续性的因素。采用探索性定性案例研究设计。在2022年1月至2月之间,对来自发件人(英国)和收件人(罗马尼亚)组织的参与者进行了九次半结构化访谈,并在必要时进行实时翻译。使用了智能逐字转录,并使用潜在主题分析对数据进行分析。收集的过程,从英国到LMIC组织的残疾设备的翻新和重新分配被映射。从访谈中确定了三个关键主题:(1)发展需要;(2)服务发展需要适当的工作关系;(3)流程整合和未来。坚强,组织之间诚实和透明的关系被认为是该倡议成功的基础。提高服务提供标准以满足LMIC组织的特定需求,支持开发合适的设备处方。发展类似的伙伴关系有可能减少不平等差距和浪费。需要全球合作和规划,以应对低收入国家获得残疾设备的挑战。
    多余残疾设备的翻新和再分配已经出现,并将继续发展,以应对低收入和中等收入国家(LMIC)对设备供应的迫切需求。以及减少英国国内设备的剩余浪费。发展强者,诚实,组织之间透明和持续的关系被认为是该倡议成功的基础,特别是提高服务提供标准,以满足LMIC组织的特定需求,为服务用户开发合适的设备处方。发展类似的伙伴关系有可能减少不平等差距和浪费。需要全球合作和规划,以应对低收入国家获得残疾设备的挑战。
    The surplus of used disability equipment contributing to waste in the UK and the lack of access to disability equipment in low- and middle-income countries (LMICs) are two issues in need of solution. To address such problems, UK charities refurbish and redistribute used disability equipment to LMICs. To date, there is a scarcity of data on how LMICs could access surplus disability equipment from UK organisations. This study aimed to collate and map out the process by which equipment is refurbished and redistributed from the UK to LMIC\'s and identify factors which influence the development and sustainability of the partnership. An explorative qualitative case study design was used. Nine semi-structured interviews were conducted with participants from sender (UK) and a receiver (Romania) organisation between January-February 2022, with real-time translation where necessary. Intelligent verbatim transcription was used, and data was analysed using latent thematic analysis. The process of collection, refurbishment and redistribution of disability equipment from the UK to a LMIC organisation was mapped. Three key themes were identified from the interviews: (1) Development out of need; (2) Service development requires an adequate working relationship; (3) Process consolidation and future. Strong, honest and transparent relationships between organisations was identified as underpinning the success of the initiative. Raising service provision standards to meet specific needs of LMIC organisations supports development of suitable equipment prescription. Development of similar partnerships has potential of reducing the inequity gap and waste. Global collaboration and planning are required to address challenges of access to disability equipment in LMICs.
    Refurbishment and redistribution of surplus disability equipment has emerged and continues to be developed as a response to a critical need for equipment provision in low- and middle-income countries (LMICs), as well as to reduce surplus waste of equipment within the UK.The development of strong, honest, transparent and continued relationships between organisations was identified as underpinning the success of the initiative, in particular raising service provision standards to meet specific needs of LMIC organisations to develop suitable equipment prescription for service users.Development of similar partnerships has the potential of reducing the inequity gap and waste. Global collaboration and planning are required to address challenges of access to disability equipment in LMICs.
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  • 文章类型: Letter
    背景:在整个研究过程中与消费者和社区的参与和伙伴关系产生了满足社区需求的高质量研究,并促进了研究转化为改进的政策和实践。伙伴关系对于涉及原住民和/或托雷斯海峡岛民(原住民)的研究至关重要,以确保文化安全。我们从设计中吸取教训,国家卫生和医学研究委员会资助的实施和进展为FERRitin水平较高的澳大利亚原住民患者进行血液透析(INFERR)临床试验。
    方法:该试验旨在了解澳大利亚原住民在贫血和高铁蛋白血症的血液透析中使用铁疗法的益处和危害。与潜在参与者的患者讨论了缺乏治疗证据。确保INFERR试验安全进行的关键要素是建立土著参考小组(IRG),该小组由位于澳大利亚高端和澳大利亚中部的透析患者组成。根据原住民社区和研究人员/学者对该项目有关当地文化差异和试验方法的建议,需要两个IRG。IRGs通过为研究材料提供投入并将研究结果转化为原住民透析患者的有效信息和政策,从而为文化安全的试验行为提供支持。在整个审判过程中,IRGs的作用已经发展到为本研究和更广泛的研究行为提供建议和指导的关键机制。由试验第一民族研究官员和简化研究概念的独立第一民族研究人员/学者向IRG提供的支持至关重要。IRG已经为参与者制定了反馈文件和流程,利益相关者,和肾脏单位。他们保证将试验结果纳入临床实践指南的文化安全建议,以确保基于证据的方法来管理高铁蛋白血症的血液透析患者的贫血。
    结论:积极的消费者和社区伙伴关系对于确保研究影响的研究行为至关重要。在INFERR临床试验中与消费者的牢固合作表明,原住民消费者将参与他们了解的研究,解决了他们的健康优先事项以及他们感到受到尊重的地方,听,并有权实现变革。
    在本文中,我们强调让消费者积极参与规划的重要性,在患有肾脏疾病且目前正在接受血液透析的原住民和/或托雷斯海峡澳大利亚人(澳大利亚原住民)中进行临床试验的实施和进行研究。该研究评估了透析患者在贫血和高水平血液检测铁蛋白时,在透析期间通过静脉接受铁的安全性和有效性。常规用于测量铁水平的测试。两个第一民族患者透析的消费者参考组,一个位于澳大利亚的顶端,另一个位于澳大利亚中部,得到第一民族研究官员和研究学者的支持,以确保研究以涉及的方式进行,尊重和重视第一民族的参与,文化,和知识。在这项研究中,积极的消费者和社区合作伙伴关系支持了强大的研究治理流程,我们认为这些流程对于知识转化对患者产生积极影响至关重要。
    BACKGROUND: Engagement and partnership with consumers and communities throughout research processes produces high quality research meeting community needs and promoting translation of research into improved policy and practice. Partnership is critical in research involving Aboriginal and/or Torres Strait Islander people (First Nations Peoples) to ensure cultural safety. We present lessons from the design, implementation and progress of the National Health and Medical Research Council funded INtravenous iron polymaltose for First Nations Australian patients with high FERRitin levels on hemodialysis (INFERR) clinical trial.
    METHODS: The trial was designed to understand the benefits and harms of iron therapy in First Nations Australians on haemodialysis with anaemia and hyperferritinaemia. The lack of evidence for treatment was discussed with patients who were potential participants. A key element ensuring safe conduct of the INFERR trial was the establishment of the Indigenous Reference Groups (IRGs) comprising of dialysis patients based in the Top End of Australia and Central Australia. Two IRGs were needed based on advice from First Nations communities and researchers/academics on the project regarding local cultural differences and approaches to trial conduct. The IRGs underpin culturally safe trial conduct by providing input into study materials and translating study findings into effective messages and policies for First Nations dialysis patients. Throughout the trial conduct, the IRGs\' role has developed to provide key mechanisms for advice and guidance regarding research conduct both in this study and more broadly. Support provided to the IRGs by trial First Nations Research Officers and independent First Nations researchers/academics who simplify research concepts is critical. The IRGs have developed feedback documents and processes to participants, stakeholders, and the renal units. They guarantee culturally safe advice for embedding findings from the trial into clinical practice guidelines ensuring evidence-based approaches in managing anaemia in haemodialysis patients with hyperferritinaemia.
    CONCLUSIONS: Active consumer and community partnership is critical in research conduct to ensure research impact. Strong partnership with consumers in the INFERR clinical trial has demonstrated that First Nations Consumers will engage in research they understand, that addresses health priorities for them and where they feel respected, listened to, and empowered to achieve change.
    In this paper, we present the importance of actively involving consumers in the planning, implementation and conduct of research using the example of a clinical trial among Aboriginal and/or Torres Strait Australians (First Nations Australians) who have kidney disease and are currently receiving haemodialysis. The study assesses how safe and effective it is for people on dialysis to receive iron given through the vein during dialysis when they have anaemia and high levels of a blood test called ferritin, a test used routinely to measure iron levels. Two consumer reference groups of First Nations patients on dialysis, one based in the Top End of Australia and the other based in Central Australia, are supported by First Nations Research Officers and Research Academics to make sure that the research is performed in a way that involves, respects and values First Nations participation, culture, and knowledge. Active consumer and community partnership in this study has supported robust research governance processes which we believe are crucial for knowledge translation to have a positive impact for patients.
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  • 文章类型: Journal Article
    非洲发展中国家面临失业危机,许多失业青年。农业已被确定为以青年为目标创造就业的战略部门,包括那些可能没有农业相关资格的人。然而,各种挑战限制了青年参与农业价值链的有效性。该研究旨在(i)确定青年对农业价值链机会的认识,(ii)确定他们对其在价值链中的作用的看法,(iii)确定他们对针对青年的农业计划的看法,以及他们对谁负责吸引青年从事农业的意见,(iv)描述农业中青年赋权的动态。使用焦点小组讨论和在线调查收集数据,并使用SPSS和NVivo进行分析。知识贫乏,对农业价值链活动和职业的认识程度低,不符合加工和零售企业就业的最低要求被确定为主要挑战。大多数青年对农业加工等非主要活动感兴趣,与农业生产相比,劳动密集型程度较低,投资回报更快。然而,促进青年参与农业的支持服务和方案主要侧重于初级活动,这表明青年的愿望和目前的支持之间不匹配。了解青年的愿望,支持青年赋权和参与价值链的观念和动力对于促进参与和制定相关和反应迅速的政策至关重要。此外,改善信息获取和提高对农业价值链的认识对于减少进入壁垒至关重要。政策制定者应将农业和粮食系统知识纳入初等教育课程,以提高青年的认识,并唤起对农业粮食系统职业的兴趣。
    Developing countries in Africa face an unemployment crisis, with many unemployed youth. Agriculture has been identified as a strategic sector for employment creation targeted at youth, including those who may not have agriculture-related qualifications. However, various challenges limit the effectiveness of youth participation in the agriculture value chain. The study aimed to (i) determine youth awareness of agricultural value-chain opportunities, (ii) determine their perception of their role in the value chain, (iii) determine their perception of agricultural programs targeting youth and their opinions on who is responsible for attracting youth into agriculture and, (iv) to characterise the dynamics of youth empowerment in agriculture. Data was collected using focus group discussions and an online survey and analysed using SPSS and NVivo. Poor knowledge, low levels of awareness of agricultural value-chain activities and careers, and not meeting the minimum requirements for employment in processing and retail businesses were identified as key challenges. Most youth were interested in non-primary activities such as agro-processing, which are less labour-intensive and have a quicker return on investment than agricultural production. However, support services and programs for promoting youth participation in agriculture mainly focus on primary activities, signifying a mismatch between youth aspirations and current support. Understanding youth aspirations, perceptions and dynamics underpinning youth empowerment and participation in value chains is critical for promoting participation and formulating relevant and responsive policies. Additionally, improving access to information and building awareness of agricultural value chains is crucial in reducing barriers to entry. Policymakers should integrate agriculture and food systems knowledge into the primary education curriculum to promote youth awareness and evoke interest in agri-food system careers at an early age.
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  • 文章类型: Journal Article
    全球根除脊髓灰质炎倡议(GPEI)帮助全球开发了标准的急性弛缓性麻痹监测(AFP)系统,包括,知识,专业知识,技术援助,和训练有素的人员。AFP监测可以补充任何疾病监测系统。
    这项研究概述了孟加拉国的AFP监测演变,它的成功和挑战性因素,以及它促进其他健康目标的潜力。
    这项混合方法研究包括灰色文献综述,调查,和关键线人访谈(KIIs)。我们从在线网站收集灰色文献,并从GPEI利益相关者收集纸质文档。在孟加拉国的六个部门进行了在线和面对面调查,包括达卡,Rajshahi,Rangpur,吉大港,Sylhet,还有Khulna,映射隐性知识思想,方法,和经验。我们还进行了KIs,然后将数据结合在重点关注的新兴主题上,包括历史,挑战,和AFP监测计划的成功。
    根据灰色文献综述,调查,还有KII,AFP监测成功地减少了孟加拉国的脊髓灰质炎。主要的促进因素是多部门合作,监测免疫医疗干事(SIMO)网络活动,社会环境,基于社区的监测,有希望的政治承诺。另一方面,人口高速增长,难以到达的地区,居住在危险地区的人们,小儿麻痹症过渡规划是重大挑战。孟加拉国还利用这些脊髓灰质炎监测资产治疗其他疫苗可预防的疾病。
    世界已经接近消灭小儿麻痹症,知识,以及法新社监视的其他资产,可用于其他健康计划。此外,可以利用其优势来对抗新出现的疾病。
    主要发现:研究发现,孟加拉国已经实现了世界标准的监测系统,包括多部门合作在内的促进因素,GPEI合作伙伴,以及政治和社区支持。然而,人口高速增长,难以到达的地区和人们,小儿麻痹症过渡规划被认为是挑战。增加知识:此外,孟加拉国现在正在利用这些脊髓灰质炎监测资产来监测其他疫苗可预防的疾病。全球卫生对政策和行动的影响:由于脊髓灰质炎仍然对一些低收入国家构成威胁,从孟加拉国的AFP监测中获得的知识可以帮助这些国家从地球上根除脊髓灰质炎病例,并为VPD和其他卫生计划服务。
    The Global Polio Eradication Initiative (GPEI) helped develop the standard acute flaccid paralysis surveillance (AFP) system worldwide, including, knowledge, expertise, technical assistance, and trained personnel. AFP surveillance can complement any disease surveillance system.
    This study outlines AFP surveillance evolution in Bangladesh, its success and challenging factors, and its potential to facilitate other health goals.
    This mixed-method study includes a grey literature review, survey, and key informant interviews (KIIs). We collected grey literature from online websites and paper documentation from GPEI stakeholders. Online and in-person surveys were conducted in six divisions of Bangladesh, including Dhaka, Rajshahi, Rangpur, Chittagong, Sylhet, and Khulna, to map tacit knowledge ideas, approaches, and experiences. We also conducted KIIs, and Data were then combined on focused emerging themes, including the history, challenges, and successes of AFP surveillance programme.
    According to the grey literature review, survey, and KII, AFP surveillance successfully contributed to decreasing polio in Bangladesh. The major facilitating factors were multi-sectoral collaboration, Surveillance Immunization Medical Officer (SIMO) network activities, social environment, community-based surveillance, and promising political commitment. On the other hand, high population growth, hard-to-reach areas, people residing in risky zones, and polio transition planning were significant challenges. Bangladesh is also utilizing these polio surveillance assets for other vaccine-preventable diseases.
    As the world is so close to eradicating polio, the knowledge, and other assets of the AFP surveillance, could be used for other health programmes. In addition, its strengths can be leveraged for combating new and emerging diseases.
    Main findings: The research found that Bangladesh has achieved a world-standard surveillance system, with facilitating factors including multi-sectoral collaboration, GPEI partners, and political and community support. However, high population growth, hard-to-reach areas and people, and polio transition planning were found to be challenges.Added knowledge: In addition, Bangladesh is now utilizing these polio surveillance assets to monitor other vaccine-preventable diseases.Global health impact for policy and action: Since polio is still a threat to some LMICs, the knowledge gained from AFP surveillance of Bangladesh could assist those countries in eradicating the cases of polio from the earth and serve VPDs and other health programmes as well.
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  • 文章类型: Journal Article
    背景:这是一项案例研究的研究提案,旨在探索一个国家组织如何与在国家心理健康改善计划中具有生活经验的人合作。质量改进被认为是应对医疗保健挑战的关键解决方案,在苏格兰,在使用质量改进作为改善健康和社会护理提供的手段方面,人们做出了巨大的努力。2016年,苏格兰医疗保健改善(HIS)建立了改善中心,其目的是领导使用一系列方法来支持团队和服务的国家改进计划。与有经验的人合作被认为是这种改进工作的关键组成部分。有,然而,对这在国家组织中的实践中表现得知之甚少。弥补证据方面的差距,加强一贯做法,需要有更多的了解来改善伙伴关系的工作。
    目的:本研究的目的是更好地了解一个全国性组织是如何与有过精神卫生服务改善计划经验的人合作的,探索人们在国家组织中合作的经验。将采用探索性案例研究方法来解决与人格障碍(PD)改善计划有关的研究问题:(1)PD改善计划中的伙伴关系如何运作?(2)伙伴关系在PD改善计划中的实际运作如何?(3)哪些因素影响PD改善计划中的伙伴关系?
    方法:将采用探索性案例研究方法与PD改善计划有关,由他领导。这项研究将探讨如何与有生活经验的人合作,在实践中描述和体现,概述影响伙伴关系工作的因素。数据将从各种定性来源收集,和分析将加深对伙伴关系工作的理解。
    结果:这项研究是斯特林大学临床博士课程的一部分,没有资金支持。数据收集工作已于2023年10月完成;预计将完成分析,结果将于2025年1月公布。
    结论:这项研究将产生与有经验的人一起工作的新知识,并将对所有以改进为重点的干预措施具有实际意义。尽管研究的主要重点是国家改进计划,预计这项研究将有助于理解所有国家公共服务组织如何与有精神卫生保健经验的人合作。
    DERR1-10.2196/51779。
    This is a research proposal for a case study to explore how a national organization works in partnership with people with lived experience in national mental health improvement programs. Quality improvement is considered a key solution to addressing challenges within health care, and in Scotland, there are significant efforts to use quality improvement as a means of improving health and social care delivery. In 2016, Healthcare Improvement Scotland (HIS) established the improvement hub, whose purpose is to lead national improvement programs that use a range of approaches to support teams and services. Working in partnership with people with lived experience is recognized as a key component of such improvement work. There is, however, little understanding of how this is manifested in practice in national organizations. To address gaps in evidence and strengthen a consistent approach, a greater understanding is required to improve partnership working.
    The aim of this study is to better understand how a national organization works in partnership with people who have lived experience with improvement programs in mental health services, exploring people\'s experiences of partnership working in a national organization. An exploratory case study approach will be used to address the research questions in relation to the Personality Disorder (PD) Improvement Programme: (1) How is partnership working described in the PD Improvement Programme? (2) How is partnership working manifested in practice in the PD Improvement Programme? and (3) What factors influence partnership working in the PD Improvement Programme?
    An exploratory case study approach will be used in relation to the PD Improvement Programme, led by HIS. This research will explore how partnership working with people with lived experience is described and manifested in practice, outlining factors influencing partnership working. Data will be gathered from various qualitative sources, and analysis will deepen an understanding of partnership working.
    This study is part of a clinical doctorate program at the University of Stirling and is unfunded. Data collection was completed in October 2023; analysis is expected to be completed and results will be published in January 2025.
    This study will produce new knowledge on ways of working with people with lived experience and will have practical implications for all improvement-focused interventions. Although the main focus of the study is on national improvement programs, it is anticipated that this study will contribute to the understanding of how all national public service organizations work in partnership with people with lived experience of mental health care.
    DERR1-10.2196/51779.
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  • 文章类型: Journal Article
    背景:公共卫生计划需要医疗保健部门的协调努力,社会服务和其他服务提供商。组织理论告诉我们,信任对于实现协作有效性至关重要。本文探讨了在临时公共卫生伙伴关系中发起和维持信任的驱动因素,以应对突然的健康威胁。
    方法:这项定性研究分析了Covid-19联系人跟踪服务的多部门合作伙伴关系的形成过程。数据是通过12次访谈收集的,两个焦点小组,一个反馈研讨会,以及对所有七个合作伙伴组织的员工进行的在线调查。目的最大变化采样用于捕获所有七个合作伙伴组织的员工的反思和经验。演绎代码方案用于识别在组织间合作中建立和维持信任的驱动因素。
    结果:关系机制源于对共同目标的承诺,共同的规范和价值观,伙伴关系结构影响了建立信任。共同的价值观和对共同目标的承诺似乎在互动时引导合作伙伴的行为,结果被认为是公平的,可靠和支持的合作伙伴。在治理结构和反映平面等级制度和共同决策权的沟通渠道方面,共同的价值观与伙伴关系的设计是一致的。当共同价值观受到侵犯时,合作伙伴组织之间就会产生紧张关系。
    结论:在合作中管理信任时,合作伙伴应该考虑像治理结构这样的结构性组成部分,组织层次结构,和通信渠道,以确保均等的配电。作业轮换,招募具有所需人格特质和态度的候选人,以及培训和发展,鼓励员工之间的组织间网络,这对于建立和加强与伙伴组织的关系至关重要。合作伙伴还应该意识到管理关系动态,通过共同的价值观引导行为,目标和优先事项,并促进伙伴组织之间的相互支持和平等。
    BACKGROUND: Public health initiatives require coordinated efforts from healthcare, social services and other service providers. Organisational theory tells us that trust is essential for reaching collaborative effectiveness. This paper explores the drivers for initiating and sustaining trust in a temporary public health partnership, in response to a sudden health threat.
    METHODS: This qualitative study analysed the formation process of a multisector partnership for a Covid-19 contact tracing service. Data was collected through 12 interviews, two focus groups, one feedback workshop, and an online survey with workforce members from all seven partner organisations. Purposive maximum variation sampling was used to capture the reflections and experiences of workforce members from all seven partner organisations. A deductive code scheme was used to identify drivers for building and sustaining trust in inter-organisational collaboration.
    RESULTS: Relational mechanisms emanating from the commitment to the common aim, shared norms and values, and partnership structures affected trust-building. Shared values and the commitment to the common aim appeared to channel partners\' behaviour when interacting, resulting in being perceived as a fair, reliable and supportive partner. Shared values were congruent with the design of the partnership in terms of governance structure and communication lines reflecting flat hierarchies and shared decision-making power. Tensions between partner organisations arose when shared values were infringed.
    CONCLUSIONS: When managing trust in a collaboration, partners should consider structural components like governance structure, organisational hierarchy, and communication channels to ensure equal power distribution. Job rotation, recruitment of candidates with the desired personality traits and attitudes, as well as training and development, encourage inter-organisational networking among employees, which is essential for building and strengthening relationships with partner organisations. Partners should also be aware of managing relational dynamics, channelling behaviours through shared values, objectives and priorities and fostering mutual support and equality among partner organisations.
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  • 文章类型: Journal Article
    背景:知识动员(KM)对于缩小儿科疼痛管理实践差距的长期证据至关重要。参与各种合作伙伴(即,那些在给定主题领域具有专业知识的人)在知识管理中是最佳实践;然而,人们对不同的合作伙伴如何参与和协作知识管理活动知之甚少。这项混合方法研究旨在了解哪些不同的KM合作伙伴群体(即,卫生专业人员,研究人员,和患者/护理人员合作伙伴)认为在儿科疼痛管理中支持KM活动。
    方法:本研究采用收敛混合方法设计。来自三个小组中的每个小组的十个伙伴参加了综合执行研究框架的访谈,他们讨论了影响儿科疼痛中KM活动的因素。然后,参与者对面试中讨论的选择因素进行评级和排名。使用反身主题分析在每个组中分析转录本。然后对特定群体的主题进行三角测量,以确定群体之间的趋同和分歧。然后进行矩阵分析以生成元主题来描述总体概念。采用描述性统计分析定量数据。
    结果:在每个合作伙伴组中开发了独特的主题,并进一步分析产生了四个元主题:(1)团队动态;(2)领导作用;(3)政策影响;(4)社会影响。各小组对团队动力的含义完全一致。虽然对领导的作用有部分共识,团体在他们所说的担任领导职务的人上有所不同。在政策影响上也有部分共识,卫生专业人员和研究人员将不同的机构描述为负责提供资金支持。最后,对社会影响有部分共识,在那里,网络的作用被视为服务于支持知识管理的不同目的。定量分析表明,伙伴群体有着相似的优先事项(例如,团队关系,沟通质量)在儿科疼痛中支持KM时。
    结论:虽然合作伙伴有许多共同的需求,他们希望如何参与知识管理活动以及他们工作的背景也有细微差别。必须引入策略来解决这些细微差别,以促进对KM的有效参与,以增加证据对小儿疼痛的影响。
    BACKGROUND: Knowledge mobilization (KM) is essential to close the longstanding evidence to practice gap in pediatric pain management. Engaging various partners (i.e., those with expertise in a given topic area) in KM is best practice; however, little is known about how different partners engage and collaborate on KM activities. This mixed-methods study aimed to understand what different KM partner groups (i.e., health professionals, researchers, and patient/caregiver partners) perceive as supporting KM activities within pediatric pain management.
    METHODS: This study used a convergent mixed-methods design. Ten partners from each of the three groups participated in interviews informed by the Consolidated Framework for Implementation Research, where they discussed what impacted KM activities within pediatric pain. Participants then rated and ranked select factors discussed in the interview. Transcripts were analyzed within each group using reflexive thematic analysis. Group-specific themes were then triangulated to identify convergence and divergence among groups. A matrix analysis was then conducted to generate meta-themes to describe overarching concepts. Quantitative data were analyzed using descriptive statistics.
    RESULTS: Unique themes were developed within each partner group and further analysis generated four meta-themes: (1) team dynamics; (2) role of leadership; (3) policy influence; (4) social influence. There was full agreement among groups on the meaning of team dynamics. While there was partial agreement on the role of leadership, groups differed on who they described as taking on leadership positions. There was also partial agreement on policy influence, where health professionals and researchers described different institutions as being responsible for providing funding support. Finally, there was partial agreement on social influence, where the role of networks was seen as serving distinct purposes to support KM. Quantitative analyses indicated that partner groups shared similar priorities (e.g., team relationships, communication quality) when it came to supporting KM in pediatric pain.
    CONCLUSIONS: While partners share many needs in common, there is also nuance in how they wish to be engaged in KM activities as well as the contexts in which they work. Strategies must be introduced to address these nuances to promote effective engagement in KM to increase the impact of evidence in pediatric pain.
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  • 文章类型: Journal Article
    背景:通过采用循证干预措施(EBIs)可以预防一半以上的癌症,包括针对营养的预防干预措施,身体活动,和烟草。具有联邦资格的健康中心(FQHC)是超过3000万美国人的主要患者护理来源,使其成为确保循证预防以促进健康公平的最佳环境。这项研究的目的是(1)确定在马萨诸塞州FQHCs中实施初级癌症预防EBIs的程度,以及(2)描述如何在内部和通过社区伙伴关系实施这些EBIs。
    方法:我们使用解释性序贯混合方法设计来评估癌症预防EBIs的实施。首先,我们收集了来自马萨诸塞州16个FQHC工作人员的34项定量调查,以确定实施EBI的频率.我们在员工样本中进行了12次定性一对一访谈,以了解如何实施调查中选择的EBI。执行研究综合框架(CFIR)指导了对执行和使用伙伴关系的背景影响的探索。定量数据进行了描述性总结,定性分析使用反身性,专题方法,从CFIR的代码开始演绎,然后感应编码其他类别。
    结果:所有FQHC都表示他们提供了基于临床的烟草干预措施,例如临床医生提供的筛查实践和戒烟药物的处方。Quitline干预措施和一些饮食/体力活动EBIs在所有FQHC都可用,但员工对渗透率的看法很低。只有38%的FQHC提供团体戒烟咨询,63%的患者转介基于手机的戒烟干预措施。我们发现多层次因素影响干预类型的实施-包括干预培训的复杂性,可用时间和人员配备,临床医生的动机,资金,以及外部政策和激励措施。虽然伙伴关系被描述为有价值的,只有一个FQHC报告使用临床-社区联系进行初级癌症预防EBIs.
    结论:马萨诸塞州FQHCs的一级预防EBIs的采用相对较高,但是需要稳定的人员配备和资金才能成功覆盖所有符合条件的患者。FQHC员工对社区伙伴关系促进改进实施的潜力充满热情-提供培训和支持以建立这些关系将是实现这一承诺的关键。
    BACKGROUND: More than half of cancers could be prevented by employing evidence-based interventions (EBIs), including prevention interventions targeting nutrition, physical activity, and tobacco. Federally qualified health centers (FQHCs) are the primary source of patient care for over 30 million Americans - making them an optimal setting for ensuring evidence-based prevention that advances health equity. The aims of this study are to (1) determine the degree to which primary cancer prevention EBIs are being implemented within Massachusetts FQHCs and (2) describe how these EBIs are implemented internally and via community partnerships.
    METHODS: We used an explanatory sequential mixed methods design to assess the implementation of cancer prevention EBIs. First, we collected 34 quantitative surveys from staff at 16 FQHCs across Massachusetts to determine the frequency of EBI implementation. We followed up with 12 qualitative one-on-one interviews among a sample of staff to understand how the EBIs selected on the survey were implemented. Exploration of contextual influences on implementation and use of partnerships was guided by the Consolidated Framework for Implementation Research (CFIR). Quantitative data were summarized descriptively, and qualitative analyses used reflexive, thematic approaches, beginning deductively with codes from CFIR, then inductively coding additional categories.
    RESULTS: All FQHCs indicated they offered clinic-based tobacco interventions, such as clinician-delivered screening practices and prescription of tobacco cessation medications. Quitline interventions and some diet/physical activity EBIs were available at all FQHCs, but staff perceptions of penetration were low. Only 38% of FQHCs offered group tobacco cessation counseling and 63% referred patients to mobile phone-based cessation interventions. We found multilevel factors influenced implementation across intervention types - including the complexity of intervention trainings, available time and staffing, motivation of clinicians, funding, and external policies and incentives. While partnerships were described as valuable, only one FQHC reported using clinical-community linkages for primary cancer prevention EBIs.
    CONCLUSIONS: Adoption of primary prevention EBIs in Massachusetts FQHCs is relatively high, but stable staffing and funding are required to successfully reach all eligible patients. FQHC staff are enthusiastic about the potential of community partnerships to foster improved implementation-providing training and support to build these relationships will be key to fulfilling that promise.
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  • 文章类型: Journal Article
    目的:本研究旨在描述患者伙伴关系的使用,正如蒙特利尔模型所定义的那样,在法国的急诊科(ED),并从医生和患者的角度报告患者伙伴关系的看法。
    方法:这项横断面研究于2020年7月至2020年10月进行。首先,向法国教学医院和非教学医院的146位ED负责人发送了一项调查,以评估服务组织中患者伙伴关系的当前做法,研究,和教学。还记录了实施这种方法的障碍和促进者。然后,我们对参与服务重组项目的患者进行了半结构化电话访谈.
    结果:共收到48份调查答复(回复率为32.9%);33.3%的受访者参与了与服务重组相关的项目,20.8%的患者参与教学项目,研究项目占4.2%。总的来说,60.4%的受访者愿意让患者参与重组或教学项目。建立患者伙伴关系的主要障碍是患者招募困难和缺乏时间。提到的主要优势是改善患者/护理人员关系和改善医疗保健的新思路。面试时,患者提到改善医疗保健的愿望,以及让不同背景和背景的人参与的必要性。过于重要的个人承诺是他们参与的最常见障碍。所有患者都认识到他们的积极作用,更普遍的是,患者参与服务重组的积极作用。
    结论:尽管这项初步研究表明法国ED负责人和伴侣患者之间对患者伙伴关系有相当积极的看法,这种方法在实践中仍然没有广泛应用。
    OBJECTIVE: This study aims to describe the use of patient partnership, as defined by the Montreal Model, in emergency departments (EDs) in France and report the perception of patient partnership from both the practitioner and patient perspectives.
    METHODS: This cross-sectional study was conducted between July 2020 and October 2020. First, a survey was sent to 146 heads of EDs in both teaching hospitals and non-teaching hospitals in France to assess the current practices in terms of patient partnership in service organization, research, and teaching. The perceived barriers and facilitators of the implementation of such an approach were also recorded. Then, semi-structured telephone interviews were carried out with patients involved in a service re-organization project.
    RESULTS: A total of 48 answers (response rate 32.9%) to the survey were received; 33.3% of respondents involved patients in projects relating to service re-organization, 20.8% involved patients in teaching projects, and 4.2% in research projects. Overall, 60.4% of the respondents were willing to involve patients in re-organization or teaching projects. The main barriers mentioned for establishing patient partnership were difficulties regarding patient recruitment and lack of time. The main advantages mentioned were the improvement in patient/caregiver relationship and new ideas to improve healthcare. When interviewed, patients mentioned the desire to improve healthcare and the necessity to involve people with different profiles and backgrounds. A too important personal commitment was the most frequently raised barrier to their engagement. All the patients recognized their positive role, and more generally, the positive role of patient engagement in service re-organization.
    CONCLUSIONS: Although this preliminary study indicates a rather positive perception of patient partnership among heads of EDs in France and partner patients, this approach is still not widely applied in practice.
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