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社区助产士和健康访视员的研究招募经验:使用理论领域框架的定性探索。

Community midwives' and health visitors' experiences of research recruitment: a qualitative exploration using the Theoretical Domains Framework.

机构信息

Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, UK.

Research Department, North West Anglia NHS Foundation Trust, Peterborough, UK.

出版信息

Prim Health Care Res Dev. 2021 Jan 29;22:e5. doi: 10.1017/S1463423621000050.

Abstract

BACKGROUND

Successful research is frequently hampered by poor study recruitment, especially in community settings and with participants who are women and their children. Health visitors (HVs) and community midwives (CMs) are well placed to invite young families, and pregnant and postnatal women to take part in such research, but little is known about how best to support these health professionals to do this effectively.

AIM

This study uses the Theoretical Domains Framework (TDF) to explore the factors that influence whether HVs and CMs invite eligible patients to take part in research opportunities.

METHOD

HVs (n = 39) and CMs (n = 22) working in four NHS Trusts and one community partnership in England completed an anonymous, online survey with open-ended questions about their experiences of asking eligible patients to take part in the research. Qualitative data were analysed using directed content analysis and inductive coding to identify specific barriers and enablers to patient recruitment within each of the 14 theoretical domains.

FINDINGS

Six key TDF domains accounted for 81% of all coded responses. These were (a) environmental context and resources; (b) beliefs about capabilities; (c) social/professional role and identity; (d) social influences; (e) goals; (f) knowledge. Key barriers to approaching patients to participate in the research were time and resource constraints, perceived role conflict, conflicting priorities, and particularly for HVs, negative social influences from patients and researchers. Enablers included feeling confident to approach patients, positive influence from peers, managers and researchers, beliefs in the relevance of this behaviour to health care and practice and good knowledge about the study procedures, its rationale and the research topic. The findings suggest that to improve research recruitment involving HVs and CMs, a package of interventions is needed to address the barriers and leverage the enablers to participant approach.

摘要

背景

成功的研究常常受到研究招募不佳的阻碍,尤其是在社区环境中,以及针对女性及其子女的参与者。健康访视员(HV)和社区助产士(CM)非常适合邀请年轻家庭以及孕妇和产后妇女参与此类研究,但对于如何最好地支持这些卫生专业人员有效地做到这一点,知之甚少。

目的

本研究使用理论领域框架(TDF)探讨影响 HV 和 CM 是否邀请合格患者参与研究机会的因素。

方法

在英格兰的四个 NHS 信托基金和一个社区合作伙伴中工作的 39 名 HV 和 22 名 CM 完成了一项匿名的在线调查,其中包含有关他们邀请合格患者参与研究的经验的开放式问题。使用定向内容分析和归纳编码对定性数据进行分析,以确定每个 14 个理论领域内患者招募的具体障碍和促进因素。

结果

六个关键的 TDF 领域占所有编码响应的 81%。这些领域是(a)环境背景和资源;(b)能力信念;(c)社会/专业角色和身份;(d)社会影响;(e)目标;(f)知识。接近患者参与研究的主要障碍是时间和资源限制、感知角色冲突、优先级冲突,特别是对于 HV 而言,还包括来自患者和研究人员的负面社会影响。促进因素包括有信心接近患者、来自同事、经理和研究人员的积极影响、对这种行为与医疗保健和实践的相关性的信念以及对研究程序、其原理和研究主题的良好了解。调查结果表明,要改善涉及 HV 和 CM 的研究招募,需要采取一揽子干预措施来解决障碍,并利用促进因素来吸引参与者。

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