Rwandan primary healthcare providers' perception of their capability in the diagnostic practice.
Rwandan primary healthcare providers' perception of their capability in the diagnostic practice.
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DOI：
10.4102/phcfm.v12i1.2197
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发表时间：
2020-09-16
影响因子：
2
通讯作者：
Schriver M
中科院分区：
文献类型：
--
作者：
Weber DL;Cubaka VK;Kallestrup P;Reventlow S;Schriver M
技能组合失衡是低收入国家初级医疗保健的全球性问题。在卢旺达，初级医疗机构（卫生中心、HC）主要由护士领导。他们必须诊断大量的健康问题。他们是否认为有能力承担这一责任还有待探讨。本研究探讨了卢旺达卫生保健中心的医疗保健提供者 (HP) 如何看待他们在诊断实践中的能力。卢旺达穆汉加区的农村和城市健康中心。对护士和临床官员进行定性、半结构化访谈，并对咨询进行观察。对调查结果进行了主题分析。卢旺达卫生部门对自己执行诊断程序的能力充满信心，尽管护士们认为责任超出了他们的专业培训范围。临床官员相信，他们的专业培训使他们能够在诊断实践中胜任和自主地发挥作用，尽管所有 HP 都高度依赖病史采集、体检和实验室测试来得出诊断。资源限制（时间、房间和实验室测试）被视为最佳执行诊断任务的障碍，并且 HP 的在职培训和监督不足。他们通过工作经验、自学和支持性同伴合作提高了诊断能力。临床官员认为自己有能力进行诊断实践。护士可以通过在职学习机会来弥补学校培训的不足，并在诊断实践中感到有能力。形成性指导计划和量身定制的教育可能被证明是有价值的，但需要进一步研究如何提高卢旺达初级医疗保健部门的 HP 诊断能力。
Skill-mix imbalance is a global concern for primary healthcare in low-income countries. In Rwanda, primary healthcare facilities (health centres, HCs) are predominantly led by nurses. They have to diagnose a multitude of health complaints. Whether they feel capable of undertaking this responsibility has yet to be explored. This study explored how healthcare providers (HPs) at Rwandan HCs perceived their capability in the diagnostic practice. Rural and urban HCs in Muhanga district, Rwanda. Qualitative, semi-structured interviews with nurses and clinical officers, and observations of consultations were made. Findings were analysed thematically. Rwandan HPs were confident in their competences to perform diagnostic procedures although nurses felt that the responsibilities lay beyond their professional training. Clinical officers believed that their professional training prepared them to function competently and autonomously in the diagnostic practice, although all HPs experienced a high dependency on medical history taking, physical examination and laboratory tests for reaching a diagnosis. Resource constraints (time, rooms and laboratory tests) were seen as a barrier to perform diagnostic tasks optimally, and HPs experienced in-service training and supervision as insufficient. They increased their diagnostic competences through work experience, self-learning and supportive peer collaboration. Clinical officers perceived themselves as capable in the diagnostic practice. Nurses may compensate for insufficient school training through in-service learning opportunities and feel capable in the diagnostic practice. Formative mentorship schemes and tailored education may prove valuable, but further research on how to improve HPs’ diagnostic capability in Rwanda’s primary healthcare sector is needed.
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影响因子：
158.5
作者：
Binagwaho, Agnes;Kyamanywa, Patrick;Goosby, Eric
通讯作者：
Goosby, Eric
DOI：
10.1111/j.1745-7599.2002.tb00142.x
发表时间：
2002-09-01
影响因子：
--
作者：
Almost, Joan;Laschinger, Heather K Spence
通讯作者：
Laschinger, Heather K Spence
DOI：
10.1111/j.1744-618x.2007.00057.x
发表时间：
2007-07-01
期刊：
International journal of nursing terminologies and classifications : the official journal of NANDA International
影响因子：
--
作者：
Hasegawa, Tomoko;Ogasawara, Chie;Katz, Edmont C
通讯作者：
Katz, Edmont C
DOI：
10.1136/bmj.b946
发表时间：
2009-04-20
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Heneghan C;Glasziou P;Thompson M;Rose P;Balla J;Lasserson D;Scott C;Perera R
通讯作者：
Perera R
影响因子：
11.8
作者：
Petti, CA;Polage, CR;Sande, MA
通讯作者：
Sande, MA