An exploration of health professionals' experiences of medicines management in elderly, hospitalised patients in Abu Dhabi
An exploration of health professionals' experiences of medicines management in elderly, hospitalised patients in Abu Dhabi
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DOI：
10.1007/s11096-015-0212-2
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发表时间：
2016-02-01
影响因子：
2.4
通讯作者：
Stewart, Derek
中科院分区：
文献类型：
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作者：
Al Shemeili, Saeed;Klein, Susan;Stewart, Derek
鉴于老年人药物相关问题的多样性，应明确定义和描述药物管理的结构和流程，以优化患者结局。有一个缺乏的研究，提供了一个深入的探索这些要素的药物管理老年患者。目的本研究探讨了医疗专业人员的经验，药物管理的老年人，住院病人在阿布扎比。研究在阿拉伯联合酋长国阿布扎比的五家主要医院进行。方法采用在线抽样问卷调查的方式，有目的地选择护士、药师和医生进行访谈。参考规范化过程理论（NPT）和理论域框架（TDF），开发了一个半结构化访谈计划，以探讨药品管理结构，过程和结果的问题。20-30分钟的面对面访谈进行录音，逐字转录，并使用框架方法进行分析。主要成果衡量标准：卫生专业人员对与药品管理有关的结构、流程和成果的深入经验。结果27名被调查者（7名护士，13名药师，7名医生）的主题饱和。定性分析提出了六个关键主题和几个次主题，涉及到以下需求：适当的多种药物治疗;对药物历史记录采取系统的方法;改进沟通和记录;提高患者对药物的依从性;支持药物选择的准则和政策，以及受过教育和培训的多学科团队。最主要的TDF行为决定因素是围绕以下问题：专业角色和身份;对能力的信念;对后果的信念;环境背景和资源;知识和目标。《不扩散核武器条约》的结构几乎没有发现一致性、认知参与、集体行动和反射性监测的证据。结论本研究中确定的关键主题表明，需要制定一个更有条理的方法来管理药物在阿布扎比老年住院患者。《不扩散核武器条约》的结构和TDF行为决定因素可以作为服务发展和实施变革的一部分。
Background Given the multiplicity of issues relating to medicines in the elderly, the structures and processes of medicines management should be clearly defined and described to optimise patient outcomes. There is a paucity of research which provides an in-depth exploration of these elements of medicines management for elderly patients. Objectives This study explored health professionals' experiences of medicines management for elderly, hospitalised patients in Abu Dhabi. Setting The research was conducted in five major hospitals in Abu Dhabi, the United Arab Emirates. Method Responses to an online sampling questionnaire were used to purposively select nurses, pharmacists and physicians for interview. A semi-structured interview schedule was developed with reference to normalization process theory (NPT) and the theoretical domains framework (TDF) to explore issues of medicines management structures, processes and outcomes. Face-to-face interviews of 20-30 min were audio-recorded, transcribed verbatim and analysed using the Framework Approach. Main outcome measures Health professionals' in-depth experiences of structures, processes and outcomes relating to medicines management. Results Saturation of themes was deemed to occur at interview 27 (7 nurses, 13 pharmacists, 7 physicians). Six key themes and several subthemes emerged from the qualitative analysis, which pertained to the need for: appropriate polypharmacy; a systematic approach to medicines history taking; improved communication and documentation; improved patients' adherence to medicines; guidelines and policies to support medicines selection, and an educated and trained multidisciplinary team. The most dominant TDF behavioural determinants were issues around: professional role and identity; beliefs about capabilities; beliefs about consequences; environmental context and resources; knowledge, and goals. NPT construct identified little evidence of coherence, cognitive participation, collective action and reflexive monitoring. Conclusion The key themes identified in this research indicate the need to develop a more structured approach to medicines management in elderly hospitalised patients in Abu Dhabi. The NPT constructs and the TDF behavioural determinants can be utilised as part of service development and implementing change.