EMERGENCY PROVIDER ATTITUDES AND BARRIERS TO UNIVERSAL HIV TESTING IN THE EMERGENCY DEPARTMENT
EMERGENCY PROVIDER ATTITUDES AND BARRIERS TO UNIVERSAL HIV TESTING IN THE EMERGENCY DEPARTMENT
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DOI：
10.1016/j.jemermed.2009.07.038
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发表时间：
2012-01-01
影响因子：
1.5
通讯作者：
Walensky, Rochelle P.
中科院分区：
文献类型：
--
作者：
Arbelaez, Christian;Wright, Elizabeth A.;Walensky, Rochelle P.
背景资料：疾病控制和预防中心（CDC）最近公布了在所有医疗机构（包括急诊室（艾德））对成人进行常规、自愿人体免疫缺陷病毒（HIV）检测的建议。研究目的：本研究的目的是探讨艾德提供者提供艾滋病毒检测的意愿，以及他们认为的障碍，以执行这些准则。研究方法：在艾德建立常规HIV检测项目之前，使用21项调查来评估艾德提供者对HIV检测的知识、态度和感知的挑战。在项目启动六个月后，再次进行相同的调查，以确定HIV检测项目的经验是否改变了提供者的看法。结果：146名供应商中有108名（74%）完成了实施前和实施后的调查。虽然大多数6个月的紧急服务提供者支持基于ED的HIV检测计划（59/108 [55%]），但只有38%（41/108）愿意在大部分或所有时间提供HIV检测。在6个月时，最常提到的提供检测的障碍是：时间不足（67/108 [62%]）、资源不足（65/108 [60%]）和对提供随访护理的担忧（64/108 [59%]）。结论：在艾德实施大规模HIV检测计划后，大多数急诊提供者支持常规HIV检测。然而，在项目启动后6个月，由于持续存在的障碍，提供者仍然不愿意提供测试。需要进一步研究，以确定可行的实施策略，最大限度地减少ED中常规HIV检测的障碍。（C）2012 Elsevier Inc.
Background: The Centers for Disease Control and Prevention (CDC) recently published recommendations for routine, voluntary human immunodeficiency virus (HIV) testing of adults in all health care settings, including the emergency department (ED). Study Objective: The objective of this study was to examine the willingness of ED providers to offer HIV testing, as well as their perceived barriers to implementation of these guidelines. Methods: Before the establishment of a routine HIV testing program in the ED, a 21-item survey was used to assess ED providers' knowledge, attitudes, and perceived challenges to HIV testing. Six months after program initiation, the identical survey was re-administered to determine whether HIV testing program experience altered providers' perceptions. Results: There were 108 of 146 (74%) providers who completed both the pre- and post-implementation surveys. Although the majority of emergency providers at 6 months were supportive of an ED-based HIV testing program (59/108 [55%]), only 38% (41/108) were willing to offer the HIV test most or all of the time. At 6 months, the most frequently cited barriers to offering a test were: inadequate time (67/108 [62%]), inadequate resources (65/108 [60%]), and concerns regarding provision of follow-up care (64/108 [59%]). Conclusions: After the implementation of a large-scale HIV testing program in an ED, the majority of emergency providers were supportive of routine HIV testing. Nevertheless, 6 months after program initiation, providers were still reluctant to offer the test due to persistent barriers. Further studies are needed to identify feasible implementation strategies that minimize barriers to routine HIV testing in the ED. (C) 2012 Elsevier Inc.