Implementing resources to support the diagnosis and management of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) in primary care: A qualitative study
Implementing resources to support the diagnosis and management of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) in primary care: A qualitative study
复制标题
DOI：
10.1186/s12875-016-0453-8
复制
发表时间：
2016-06-04
影响因子：
2.9
通讯作者：
Chew-Graham, Carolyn A.
中科院分区：
文献类型：
--
作者：
Bayliss, Kerin;Riste, Lisa;Chew-Graham, Carolyn A.
背景资料：以前的研究已经强调，许多全科医生缺乏信心和知识来诊断和管理CFS/ME. Following发展的人的在线培训模块的全科医生，并为患者的信息包和DVD，本研究探讨了在何种程度上这些资源可以实施在常规的初级care.Methods：半结构化的定性访谈完成了英格兰西北部的患者和全科医生。所有的采访都转录和分析使用开放的探索性主题编码。在这一主题分析之后，作者进行了进一步的理论驱动的数据分析的指导下，规范化过程Theory.Results：当使用与研究团队的建议，信息资源和培训被认为是有益的CFS/ME. However，在这项研究中，47%的患者没有收到的信息包从他们的GP。当信息包被使用时，它往往是不完整的，在邮寄中发送，全科医生没有与病人讨论材料。由于时间压力和对低流行率、有争议、难以管理的条件的重视程度较低，21个实践中只有13个完成了培训模块。当该模块完成时，许多全科医生表示，保留关键信息是不可行的，因为他们看到的患者很少。由于病情的复杂性，全科医生还认为，CFS/ME的诊断和管理应发生在专科护理setting.Conclusion：虽然障碍的培训和资源的实施CFS/ME仍然存在，有必要支持CFS/ME患者获得可靠的，基于证据的信息以外的初级保健。我们的研究结果表明，未来的研究应该为患者开发一个在线资源，以支持自我管理。
Background: Previous research has highlighted that many GPs lack the confidence and knowledge to diagnose and manage people with CFS/ME. Following the development of an online training module for GPs, and an information pack and DVD for patients, this study explored the extent to which these resources can be implemented in routine primary care.Methods: Semi structured qualitative interviews were completed with patients and GPs across North West England. All interviews were transcribed and analysed using open exploratory thematic coding. Following this thematic analysis, the authors conducted a further theory-driven analysis of the data guided by Normalisation Process Theory.Results: When used in line with advice from the research team, the information resource and training were perceived as beneficial to both patients and GPs in the diagnosis and management of CFS/ME. However, 47 % of patients in this study did not receive the information pack from their GP. When the information pack was used, it was often incomplete, sent in the post, and GPs did not work with patients to discuss the materials. Only13 out of 21 practices completed the training module due to time pressures and the low priority placed on low prevalence, contentious, hard to manage conditions. When the module was completed, many GPs stated that it was not feasible to retain the key messages as they saw so few patients with the condition. Due to the complexity of the condition, GPs also believed that the diagnosis and management of CFS/ME should take place in a specialist care setting.Conclusion: While barriers to the implementation of training and resources for CFS/ME remain, there is a need to support CFS/ME patients to access reliable, evidence based information outside primary care. Our findings suggest that future research should develop an online resource for patients to support self-management.