Interprofessional collaboration

专业间合作
  • 文章类型: Journal Article
    背景:这项研究描述了针对过渡年(TY)居民的独特的为期两周的基于模拟的医学教育(SBME)轮换。在旋转过程中,居民完全融入模拟团队,积极参与基于临床的跨专业方案,程序技术,和混合现实体验。居民还在接收内容专家反馈的同时创建并运行自己的模拟。我们评估了轮换在为TY毕业生准备特定的高级居留课程方面的有效性。
    方法:一项回顾性调查评估了参加独特的两周模拟轮换的11名TY居民的经历。调查评估了居民对该计划价值和技能发展的看法,课程设计,与未来实践相关的场景,并准备制定未来的情景。
    结果:居民(12名居民中有11名,92%的响应率)压倒性地认可了模拟轮换(100%肯定,45.45%极有价值)。该计划明显改善了核心临床技能(报告了100%的改善),并培养了未来实践的自我效能感。情景相关性高(81.82%高度相关)。协作和沟通技巧显示出希望(72.73%的积极),同时突出了未来改进的潜在领域。居民一致同意有效的时间分配和该计划对汇报技能的价值。值得注意的是,91%强烈支持针对居民的模拟训练。
    结论:先前的TY居民认为为期两周的模拟很有价值,大多数人认为这种经验在多个调查问题中非常有价值。居民绝大多数表示倾向于进行针对居民的培训,建议未来开发专门定制的模块和增强的汇报会。调查结果强调了该计划的有效性和成功实施到TY居住课程中。
    BACKGROUND: This study describes a unique two-week simulation-based medical education (SBME) rotation for transitional year (TY) residents. During the rotation, residents are fully integrated into the simulation team, actively participating in clinically based interprofessional scenarios, procedural techniques, and mixed reality experiences. Residents also created and ran their own simulations while receiving content expert feedback. We evaluated the rotation\'s effectiveness in preparing TY graduates for their specific advanced residency track.
    METHODS: A retrospective survey evaluated the experiences of 11 TY residents who participated in a unique two-week simulation rotation. The survey assessed residents\' perceptions of the program\'s value and skill development, course design, scenario relevance to future practice, and preparedness to develop future scenarios.
    RESULTS: Residents (11 out of 12 residents, 92% response rate) overwhelmingly endorsed the simulation rotation (100% positive, 45.45% extremely valuable). The program demonstrably improved core clinical skills (100% reported improvement) and fostered self-efficacy for future practice. Scenario relevance was high (81.82% highly relevant). Collaboration and communication skills showed promise (72.73% positive) while highlighting a potential area for future refinement. Residents unanimously agreed on effective time allocation and the program\'s value for debriefing skills. Notably, 91% strongly supported residency-specific simulation training.
    CONCLUSIONS: The two-week simulation was perceived by prior TY residents as valuable, with a majority finding the experience highly valuable across multiple survey questions. Residents overwhelmingly expressed a preference for residency-specific training, suggesting future development of specialty-tailored modules and enhanced debriefing sessions. The findings highlight the program\'s effectiveness and successful implementation into a TY residency curriculum.
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  • 文章类型: Journal Article
    灾难护理在满足受大规模紧急情况影响的弱势群体的健康需求方面发挥着至关重要的作用。然而,灾难护理面临许多挑战,包括准备,物流,教育,伦理,恢复和合法性。为了在危机期间提高医疗保健系统的有效性,必须克服这些问题。这份雨伞评论,使用乔安娜·布里格斯研究所(JBI)方法进行,综合来自24项研究的数据,以确定改善灾难护理的关键策略。审查突出了九个关键主题:教育和培训,研究与开发,政策和组织支持,技术进步,心理准备和支持,评估和评价,特定角色的准备,跨专业合作与文化能力,道德与决策。检讨强调教育的重要性,技术进步,心理支持,以及加强灾难护理准备和响应工作的跨专业合作。这些要素对于在紧急情况下提高患者的治疗效果至关重要,并有助于建立更具弹性的医疗保健系统。这种全面的分析提供了对加强灾难护理至关重要的各个方面的宝贵见解。通过在这九个主题内实施循证战略,护理专业可以提高其有效管理和应对受灾人口复杂需求的能力,最终在紧急情况下改善患者护理和预后。
    Disaster nursing plays a vital role in addressing the health needs of vulnerable populations affected by large scale emergencies. However, disaster nursing faces numerous challenges, including preparedness, logistics, education, ethics, recovery and legalities. To enhance healthcare system effectiveness during crises, it is essential to overcome these issues. This umbrella review, conducted using the Joanna Briggs Institute (JBI) methodology, synthesizes data from 24 studies to identify key strategies for improving disaster nursing. The review highlights nine key themes: Education and Training, Research and Development, Policy and Organizational Support, Technological Advancements, Psychological Preparedness and Support, Assessment and Evaluation, Role-Specific Preparedness, Interprofessional Collaboration and Cultural Competence, and Ethics and Decision-Making. The review emphasizes the importance of education, technological advancements, psychological support, and interprofessional collaboration in bolstering disaster nursing preparedness and response efforts. These elements are crucial for enhancing patient outcomes during emergencies and contributing to a more resilient healthcare system. This comprehensive analysis provides valuable insights into the various aspects essential for enhancing disaster nursing. By implementing evidence-based strategies within these nine themes, the nursing profession can enhance its capacity to effectively manage and respond to the complex needs of disaster-affected populations, ultimately improving patient care and outcomes during emergencies.
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  • 文章类型: Journal Article
    背景:2018年,荷兰政府启动了SolidStart计划,为每个孩子提供人生的最佳开端。关键计划要素是对怀孕和儿童发展的生物心理社会观点,并刺激社会和健康领域之间的地方合作,特别关注(未来)弱势家庭。制定并实施了两个方案,促进产妇和社会护理专业人员之间的跨专业合作,以优化弱势孕妇的护理,2017年在格罗宁根,2021年在南林堡。本文介绍了这些计划的实施程度以及相关专业人员对影响计划实施的决定因素的看法。
    方法:我们于2021年和2022年在两个荷兰地区进行了一项混合方法研究,格罗宁根和南林堡。调查问卷被送到初级保健助产士那里,医院的助产士,产科医生(即产妇护理专业人员),(协调)青年保健护士和社会工作者(即社会护理专业人员),参与程序的执行。与相关专业人员进行了半结构化访谈,以丰富定量数据。使用Fleuren的实施模型收集和分析定量和定性数据。
    结果:调查问卷(n=60)和访谈(n=28)的结果表明,这两个地区的专业人员对实施的计划普遍持积极态度。然而,格罗宁根对该计划的了解和使用有限。关于创新和用户的决定因素,提到了促进执行的因素。产妇护理专业人员更喜欢一般,识别与助产士日常实践相关的漏洞的对话方式。低门槛,与专业人员之间明确的转诊和咨询协议的个人接触有助于实施。专业人员一致认为,适当确定脆弱性并将妇女转介给适当的护理是一项重要任务,有助于更好的护理。关于组织的决定因素,专业人士指出了成功实施的一些先决条件,如明确描述的角色和责任,跨专业培训,时间和财政资源。
    结论:在实施产妇护理和社会护理之间的跨专业合作方面需要改进的领域主要集中在组织的决定因素上,应该在区域和国家层面解决。此外,可持续实施需要对影响因素的持续认识和评估过程,适应和支持目标群体。
    BACKGROUND: In 2018, the Dutch government initiated the Solid Start program to provide each child with the best start in life. Key program elements are a biopsychosocial perspective on pregnancy and children\'s development and stimulating local collaborations between social and health domains, with a specific focus on (future) families in vulnerable situations. Two programs for interprofessional collaboration between maternity and social care professionals to optimize care for pregnant women in vulnerable situations were developed and implemented, in Groningen in 2017 and in South Limburg in 2021. This paper describes the extent of implementation of these programs and the perceptions of involved professionals about determinants that influence program implementation.
    METHODS: We conducted a mixed-methods study in 2021 and 2022 in two Dutch regions, Groningen and South Limburg. Questionnaires were sent to primary care midwives, hospital-based midwives, obstetricians (i.e. maternity care professionals), (coordinating) youth health care nurses and social workers (i.e. social care professionals), involved in the execution of the programs. Semi-structured interviews were held with involved professionals to enrich the quantitative data. Quantitative and qualitative data were collected and analyzed using Fleuren\'s implementation model.
    RESULTS: The findings of the questionnaire (n = 60) and interviews (n = 28) indicate that professionals in both regions are generally positive about the implemented programs. However, there was limited knowledge and use of the program in Groningen. Promoting factors for implementation were mentioned on the determinants for the innovation and the user. Maternity care professionals prefer a general, conversational way to identify vulnerabilities that connects to midwives\' daily practice. Low-threshold, personal contact with clear agreements for referral and consultation between professionals contributes to implementation. Professionals agree that properly identifying vulnerabilities and referring women to appropriate care is an important task and contributes to better care. On the determinants of the organization, professionals indicate some preconditions for successful implementation, such as clearly described roles and responsibilities, interprofessional training, time and financial resources.
    CONCLUSIONS: Areas for improvement for the implementation of interprofessional collaboration between maternity care and social care focus mainly on determinants of the organization, which should be addressed both regionally and nationally. In addition, sustainable implementation requires continuous awareness of influencing factors and a process of evaluation, adaptation and support of the target group.
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  • 文章类型: Journal Article
    背景:初级卫生保健中的协作实践提高了护理质量和安全性。在法国,初级卫生保健专业人员越来越多地合作。全科医生(GP)和社区药剂师(CPs)之间的联系是一个重要因素。然而,GP和CP之间的有效合作很难发展和形式化。跨专业教育已被确定为准备“协作实践准备的专业人员”的必要步骤。我们旨在确定去年GP和CP学生的跨专业培训需求,以发展跨专业合作。
    方法:我们使用受职业教学法启发的方法对培训需求进行了分析。我们在2022年通过对CP和GP的个人半指导访谈收集了数据。在每个阶段,我们旨在确定职业教学法的要素,以参考框架的形式推断培训需求:表观能力,象征性的情况和行为特征。我们进行了初步的演绎主题分析,以确定这两个职业的明显能力,使用这些能力的象征性情况,以及在这些情况下使用的表演特征。我们进行了归纳分类,以定义协作能力和情境家族,并对这种GP-CP协作的行为进行建模。
    结果:我们定义了“在跨专业环境中有效协作,以便在各种专业情况下应对个人领域中的护理问题”的能力。我们通过基于两种相互作用的动力的三种能力来描述它:一次性交流和结构化合作。各种通信工具有助于实现这些交互。我们以概念图的形式对GP-CP协作的行为进行了建模。
    结论:CP和GP之间的合作实现了一种可以整合到其专业参考中的能力。这种能力,题为“在跨专业环境中有效合作,以应对一个人所在地区的护理问题”,表现在各种专业情况下。它基于两个平行和相互作用的动态:一次性交流和持久合作的动态。因此,这项研究为全科医生和药房居民之间这种协作技能的发展奠定了基础。
    BACKGROUND: Collaborative practice in primary health care increases care quality and security. In France, primary health care professionals increasingly work together. The link between general practitioners (GPs) and community pharmacists (CPs) is an important element. Nevertheless, effective collaboration between GPs and CPs is difficult to develop and formalize. Interprofessional education has been identified as a necessary step to prepare \"collaborative practice-ready professionals\". We aimed to identify the interprofessional training needs of last-year GP and CP students to develop interprofessional collaborations.
    METHODS: We conducted an analysis of training needs using a method inspired by occupational didactics. We collected data through individual semidirective interviews with CPs and GPs in 2022. At each stage we aimed to identify the elements of the occupational didactics to deduce the training needs in the form of a frame of reference: apparent competencies, emblematic situations and acting characteristics. We conducted an initial deductive thematic analysis to identify the apparent competencies of the two professions, the emblematic situations in which these competencies are used, and the acting characteristics used in these situations. We made an inductive categorization to define the collaborative competence and the families of situations and to model the actions of this GP-CP collaboration.
    RESULTS: We defined the competency \"to collaborate effectively in an interprofessional setting in order to respond to care issues in one\'s territory\" expressed in various professional situations. We described it by three capacities based on two interacting dynamics: one-off exchanges and structured collaborations. Various communication tools facilitate the implementation of these interactions. We modeled the actions of the GP-CP collaboration in the form of a conceptual map.
    CONCLUSIONS: The collaboration between the CP and the GP implements a competency that could be integrated into their professional referential. This competency, entitled \"collaborating effectively in interprofessional settings to respond to care issues in one\'s territory\", is expressed in a variety of professional situations. It is based on two parallel and interacting dynamics: one-off exchanges and a dynamic of lasting collaboration. This study thus lays the groundwork for the development of this collaborative skill among general practice and pharmacy residents.
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  • 文章类型: Journal Article
    初级医疗保健(PHC)轮换将医学生在第4年或第5年期间在农村地区医院中放置4周。这种轮换是斯泰伦博斯大学医学与健康科学学院三个学术单位之间的合作。在这一轮换期间的学习活动包括参与一个纵向的面向社区的初级保健项目,对残疾人进行以康复为导向的家访,并在门诊和门诊基础上评估和治疗出现未分化问题的患者。在农村环境中工作一个月为学生提供了与医疗团队建立有意义的关系的机会,病人和社区,同时学习协作团队合作和社区。对患者的跨专业护理和社区评估的批判性反思是学生学习和评估的关键组成部分。证明专业间合作在PHC中的重要性,这种综合训练模式已经收到了,并继续接收,来自学生和相关临床医生的积极反馈。对后勤和学术支持的关注在确保学生的最佳学习中起着至关重要的作用。一种涉及多个学术单元的综合方法,对于那些正在考虑在农村PHC环境中培训学生的人,强烈建议各种医疗保健专业和社区。
    The primary healthcare (PHC) rotation places medical students in rural district hospitals for 4 weeks during their 4th or 5th year. This rotation is a collaboration among three academic units at Stellenbosch University\'s Faculty of Medicine and Health Sciences. Learning activities during this rotation include participation in a longitudinal community-oriented primary care project, conducting rehabilitation-oriented home visits to persons with disabilities, and assessing and treating patients presenting with undifferentiated problems on an in- and outpatient basis. Working in rural contexts for a month affords students opportunities to foster meaningful relationships with the healthcare team, patients and the community, while learning about collaborative teamwork and communities. Critical reflections about the interprofessional care of patients and a community evaluation are key components of the students\' learning and assessment. Demonstrating the importance of interprofessional collaboration in PHC, this integrated training model has received, and continues to receive, positive feedback from students and the clinicians involved. Attention to logistics and academic support plays a crucial role in ensuring optimal learning for students. An integrated approach that involves multiple academic units, various healthcare professions and communities is strongly recommended for those who are considering training students in rural PHC environments.
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  • 文章类型: Journal Article
    背景:农村家庭医生的角色不断发展,以适应老龄化社会的全面护理需求。对于农村地区的老年人来说,康复对于确保他们能够继续进行日常生活活动至关重要。在这个人群中,住院后的顺利出院至关重要,需要对多种疾病进行管理,康复治疗师可能需要家庭医生的支持才能达到最佳效果。因此,这项研究旨在调查农村家庭医生在患者康复中角色的变化。
    方法:在日本农村医院对农村家庭医生和康复治疗师进行了人种学分析。采用建构主义扎根理论方法作为定性研究方法。数据是通过实地笔记和半结构化访谈从参与者那里收集的。
    结果:使用扎根的理论方法,关于在农村社区老年患者的康复中建立家庭医生和治疗师之间的有效跨专业合作,制定了以下三个主题:1)建立相互理解和心理安全感;2)改善医疗保健专业人员与患者之间的关系;3)在农村家庭医学中创造新角色以满足不断变化的需求。
    结论:确保家庭医学和康复部门之间的持续对话有助于建立理解,增强知识,加强医护人员之间的相互尊重,让工作更愉快。部门之间的持续合作也改善了专业人员与患者之间的关系,在协作治疗范式中建立信任,并支持以患者为中心的家庭医学方法。在这个框架内,了解家庭医生的能力可以导致他们在农村医院中建立新的角色。家庭医学在社区医院的老年护理中起着至关重要的作用,特别是在农村初级保健机构。应在其他环境中研究家庭医学在医院中的作用,以改善老年护理并促进医疗保健专业人员之间的相互学习和改进。
    BACKGROUND: The role of rural family physicians continues to evolve to accommodate the comprehensive care needs of aging societies. For older individuals in rural areas, rehabilitation is vital to ensure that they can continue to perform activities of daily living. In this population, a smooth discharge following periods of hospitalization is essential and requires management of multimorbidity, and rehabilitation therapists may require support from family physicians to achieve optimal outcomes. Therefore, this study aimed to investigate changes in the roles of rural family physicians in patient rehabilitation.
    METHODS: An ethnographic analysis was conducted with rural family physicians and rehabilitation therapists at a rural Japanese hospital. A constructivist grounded theory approach was applied as a qualitative research method. Data were collected from the participants via field notes and semi-structured interviews.
    RESULTS: Using a grounded theory approach, the following three themes were developed regarding the establishment of effective interprofessional collaboration between family physicians and therapists in the rehabilitation of older patients in rural communities: 1) establishment of mutual understanding and the perception of psychological safety; 2) improvement of relationships between healthcare professionals and their patients; and 3) creation of new roles in rural family medicine to meet evolving needs.
    CONCLUSIONS: Ensuring continual dialogue between family medicine and rehabilitation departments helped to establish understanding, enhance knowledge, and heighten mutual respect among healthcare workers, making the work more enjoyable. Continuous collaboration between departments also improved relationships between professionals and their patients, establishing trust in collaborative treatment paradigms and supporting patient-centered approaches to family medicine. Within this framework, understanding the capabilities of family physicians can lead to the establishment of new roles for them in rural hospitals. Family medicine plays a vital role in geriatric care in community hospitals, especially in rural primary care settings. The role of family medicine in hospitals should be investigated in other settings to improve geriatric care and promote mutual learning and improvement among healthcare professionals.
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  • 文章类型: Journal Article
    在瑞典的学校卫生服务中,当地已经采取了一些举措,使用处方体育活动(PAP)来鼓励不运动的儿童变得更加活跃。先前的研究表明,跨专业合作在促进儿童体育锻炼中起着至关重要的作用,以及促进学校的健康。然而,在学校环境中,儿童缺乏关于PAP的知识,包括医疗和教育人员如何共同努力,鼓励被推荐的PAP儿童。因此,这项研究旨在探讨在学校环境中关于处方上的身体活动的跨专业合作的感知促进者和障碍,从专业人士的角度来看。对21名在学校环境中使用该方法的专业人员进行了半结构化访谈。数据采用反身性主题分析法进行分析。结果揭示了在学校环境中PAP跨专业合作的障碍和促进者,正如专业人士所认为的那样。学校机构内部的组织和结构障碍阻碍了合作,虽然对人民行动党的共同承诺,以建立共识为特征,作为一个促进因素。针对学校环境中儿童的PAP仍然是一个尚未探索的领域,需要进一步研究。
    In Swedish school health services, local initiatives have been taken to use physical activity on prescription (PAP) to encourage physically inactive children to become more active. Previous research shows that interprofessional collaboration plays a crucial role in promoting physical activity in children, as well as in promoting health in schools. However, there is a lack of knowledge about PAP for children in the school setting, including how medical and educational staff can work together to encourage children who have been recommended PAP. Therefore, this study aims to explore the perceived facilitators and barriers concerning interprofessional collaboration regarding physical activity on prescription in the school setting, as viewed from the professionals\' perspectives. Semi-structured interviews were conducted with 21 professionals who work with the method in school settings. The data were analyzed using Reflexive Thematic Analysis. The results reveal both barriers and facilitators for interprofessional collaboration on PAP in the school setting, as perceived by professionals. Organizational and structural obstacles within school institutions hinder collaboration, while a shared commitment to PAP, characterized by consensus-building, acts as a facilitating factor. PAP for children in a school setting is still an unexplored area and further research is required.
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  • 文章类型: Journal Article
    背景:家庭-专业合作对于提高脑瘫儿童及其照顾者的结局很重要。目的:这项研究检查了实施家庭专业合作实践模式对脑瘫儿童及其照顾者的影响。材料和方法:随机,单盲比较研究包括28名物理治疗师,44名2至12岁的脑瘫儿童,和他们的照顾者。实验组的物理治疗师在两个疗程(每个3小时)的过程中接受了如何在治疗中实施合作的培训。儿童的成就目标范围率是使用目标达成量表测量的,护理人员的生活质量使用世界卫生组织的生活质量简报进行评估,并使用Zarit负担访谈评估照顾者负担。结果:所有儿童的目标达成量变化率都有改善(p=0.002),组间无显著差异(p<0.44)。然而,观察到一组×时间相互作用。对照组儿童的两次评估之间的儿童目标达成率下降,而实验组的目标达成比例变化率稳定。世界卫生组织生活质量简报领域没有时间和群体的主要影响或时间×群体的相互作用,时间对Zarit负担访谈没有主要影响,但组间有主要影响(p=0.03),部分eta平方=0.11有利于实验组。结论:家庭-专业合作实践模式可能是积极改善脑瘫儿童及其照顾者预后的潜在实践。
    Background: Family-professional collaboration is important to enhance the outcomes for children with cerebral palsy and their caregivers. Aims: This study examined the effect of implementing a family-professional collaboration practice model on children with cerebral palsy and their caregivers. Materials and methods: A randomized, single-blind comparative study included 28 physical therapists, 44 children with cerebral palsy between the ages of 2 and 12 years old, and their caregivers. Physical therapists in the experimental group received training in how to implement collaboration in their therapy sessions over the course of two sessions (3 h each). The children\'s achievement goal-range rate was measured using the Goal Attainment Scaling, the caregivers\' quality of life was assessed using the World Health Organization Quality of Life-Brief, and the caregiver burden was evaluated using the Zarit Burden Interview. Results: All children showed improvement on the Goal Attainment Scaling change rate (p = 0.002), with no significant differences between groups (p < 0.44). However, a group × time interaction was observed. The Children Goal Attainment Scaling rate decreased between the two assessment sessions for children in the control group, while the Goal Attainment Scaling change rate was steady for the experimental group. There were no main effects of time and group or interaction of time × group reported on World Health Organization Quality of Life-Brief domains and no main effect of time on the Zarit Burden Interview, but there was a main effect between groups (p = 0.03), with partial eta square = 0.11 in favor of the experimental group. Conclusions: The family-professional collaboration practice model could be a potential practice to positively improve the outcomes in children with cerebral palsy and their caregivers.
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  • 文章类型: Journal Article
    背景:医生和药剂师之间的合作促进了药物优化工作的开展。在取消处方的背景下,药剂师的角色通常被描述为向医生提出处方建议。关于药剂师愿意提出处方建议以及他们与瑞士初级保健机构医生的跨专业合作的相关因素知之甚少。
    目的:探讨药剂师对老年人用药优化和取消处方的看法,以及他们在瑞士初级保健机构中进行跨专业合作的偏好。
    方法:在这项横断面研究中,瑞士药剂师协会的1000名药剂师成员被邀请参加药物优化调查,开药,和跨专业合作。该调查包含3例年龄≥80岁的多药患者,在日常生活活动(ADL)和心血管疾病(CVD)中具有不同程度的依赖性。对于每个案例小插图,药剂师被问及他们是否会停用以及哪种药物。我们通过病例小插图计算药剂师放弃处方的意愿比例,并进行多水平逻辑回归以评估CVD之间的关联,ADL,和放弃处方的意愿。
    结果:一百三十八(14%)药剂师回答了调查:113(82%)是女性,他们的平均年龄为44岁(SD=11),66%(n=77)报告从未接受过关于如何进行结构化药物审查的任何具体培训.83名(72%)的药剂师报告说,他们有信心识别开处方的机会。所有药剂师都愿意在所有小插曲中停用≥1种药物。患有CVD的患者服用处方药的几率较低(OR=0.27,95CI0.21至0.36)。ADL依赖性较高,开处方的意愿较低(中等依赖性与低依赖性:OR=0.68,95CI0.54至0.87,高依赖性与低依赖性:OR=0.72,95CI0.56至0.91)。然而,ADL依赖性对患者开处方意愿的影响被CVD病史显著改变.一百零五位药剂师(97%)报告说,每周至少一次与医生互动,以澄清有关处方的问题,而88位药剂师(81%)希望更多地参与开药和药物审查。
    结论:药剂师愿意为老年多药患者提出处方建议,但三分之二的人报告说,他们没有接受过关于如何进行结构化药物审查的正式培训.药剂师希望更多地参与药物审查和开处方的过程,这应该在瑞士初级保健环境中加以利用。
    BACKGROUND: Collaboration between physicians and pharmacists facilitates the conduct of medication optimisation efforts. In the context of deprescribing, pharmacists\' roles are often described as making deprescribing recommendations to physicians. Little is known about factors associated with pharmacists\' willingness to make deprescribing recommendations and their interprofessional collaboration with physicians in Swiss primary care settings.
    OBJECTIVE: To explore pharmacists\' perspectives on medication optimisation and deprescribing in older adults, and their preferences for interprofessional collaboration in Swiss primary care settings.
    METHODS: In this cross-sectional study, a random sample of 1000 pharmacist members of the Swiss Pharmacists Association pharmaSuisse was invited to participate in a survey on medication optimisation, deprescribing, and interprofessional collaboration. The survey contained three case vignettes of multimorbid patients with polypharmacy aged ≥ 80 years old, with different levels of dependency in activities in daily living (ADL) and cardiovascular disease (CVD). For each case vignette, pharmacists were asked if and which medications they would deprescribe. We calculated proportions of pharmacists\' willingness to deprescribe by case vignette and performed a multilevel logistic regression to assess associations between CVD, ADL, and willingness to deprescribe.
    RESULTS: One hundred thirty-eight (14%) pharmacists responded to the survey: 113 (82%) were female, their mean age was 44 years (SD = 11), and 66% (n = 77) reported having never received any specific training on how to conduct structured medication reviews. Eighty-three (72%) pharmacists reported to be confident in identifying deprescribing opportunities. All pharmacists were willing to deprescribe ≥ 1 medication in all vignettes. Patients with CVD were at lower odds of having medications deprescribed (OR = 0.27, 95%CI 0.21 to 0.36). Willingness to deprescribe was lower with higher dependency in ADL (medium versus low dependency: OR = 0.68, 95%CI 0.54 to 0.87, high versus low dependency: OR = 0.72, 95%CI 0.56 to 0.91). However, the effect of dependency in ADL on willingness to deprescribe was significantly modified by the history of CVD. One hundred five pharmacists (97%) reported to interact with physicians to clarify questions regarding prescriptions at least once a week and 88 (81%) wished to be more involved in deprescribing and medication review.
    CONCLUSIONS: Pharmacists were willing to make deprescribing suggestions for older patients with polypharmacy, but two-thirds reported having received no formal training on how to perform structured medication reviews. Pharmacists would like to be more involved in the process of medication review and deprescribing, which should be leveraged in the context of Swiss primary care settings.
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  • 文章类型: Journal Article
    在跨专业合作中使用通用语言至关重要。世界卫生组织的国际功能分类,残疾与健康(ICF)已被确定为跨专业合作和确定客户需求的统一框架。高等教育机构(HEI)为学生提供ICF框架教育,但足以使毕业的专业人员在临床工作中实施ICF吗?根据我们的经验,HEI提供的ICF教育不符合临床实践的要求,这可能是由于在向学生教授ICF(教育)方面的差距以及向已经从事康复(培训)的专业人员教授ICF的具体要求。本文讨论了ICF培训在实践中的需求以及解决方法。尽管许多康复中心专业人员以前曾接受过HEI提供的ICF教育,康复中心认为有必要开发自己的实用培训材料,以应用于自己的环境。总的来说,在名为INPRO的Erasmus项目期间开发了18种基于ICF的不同材料,以促进康复中心以人为中心和跨专业实践。使用真实案例的实践培训被认为是有价值的。可以与HEI合作进一步发展,反之亦然。它也可以用来教学生,即,未来的同事为了深化和拓宽基于ICF的不同材料的整合,重要的是继续高等教育与临床实践之间的互动讨论,以及管理层和员工之间的关系。
    The use of a common language in interprofessional collaboration is essential. The World Health Organization\'s International Classification of Functioning, Disability and Health (ICF) has been identified as a unifying framework for interprofessional collaboration and the identification of client needs. Higher education institutions (HEIs) offer ICF framework education to students but is it enough to enable graduated professionals to implement the ICF in clinical work? In our experience, the ICF education provided by HEIs does not meet the requirements of clinical practice, which might be due to gaps in teaching ICF to students (education) and specific requirements for teaching ICF to professionals already working in rehabilitation (training). This paper discusses the need for the ICF training in practice and ways to address it. Although many rehabilitation center professionals had previously received ICF education provided by the HEIs, the rehabilitation centers felt the need to develop their own practical training materials that could be applied to their own environment. Overall, 18 different ICF-based materials were developed during the Erasmus+ project called INPRO to promote person-centered and interprofessional practice in the rehabilitation centers. The practical training using real cases was considered valuable. It could be further developed in cooperation with HEIs and vice versa. It could also be used to teach students, i.e., future colleagues. To deepen and broaden the integration of the different materials based on the ICF, it is important to continue the interactive discussion between HEIs and clinical practice, and between management and its staff.
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