Motivation to move fast, motivation to wait and see: The association of prevention and promotion focus with clinicians' implementation of the JNC-7 hypertension treatment guidelines.
Motivation to move fast, motivation to wait and see: The association of prevention and promotion focus with clinicians' implementation of the JNC-7 hypertension treatment guidelines.
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快速行动的动机，观望的动机：预防和推广重点与临床医生实施JNC-7高血压治疗指南的关联
DOI：
10.1111/jch.14332
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发表时间：
2021-09
期刊：
影响因子：
--
通讯作者：
Veazie P
中科院分区：
文献类型：
--
作者：
Sanders M;Fiscella K;Hill E;Ogedegbe O;Cassells A;Tobin JN;Williams S;Veazie P
在美国，大约有一半的成年人被诊断患有高血压（HTN）。不幸的是，只有不到三分之一的人的病情得到控制。临床医生通常对使用HTN指南以实现HTN治疗目标持积极态度;然而，实际吸收率仍然很低。在实践中，临床医生差异的基础因素知之甚少。了解临床医生完成目标的个人动机与他们对联合国家委员会HTN指南的吸收之间的关系。作者使用调节焦点理论（RFT，即预防和促进焦点），一个实证支持的动机理论，作为一个指导框架来检查的关系。作者假设，对于血压不受控制的患者，高度关注预防的临床医生将更频繁地报告遵循指南，并且随访访视间隔更短。临床医生（n = 27）在联邦合格的卫生中心（n = 8）照顾诊断为HTN的成年患者（n = 8605）。收缩压（SBP）不受控制（≥ 140 mm Hg）患者的临床医生预防和促进重点评分以及访视间隔天数。与RFT一致，60%的以预防为重点的临床医生报告说，他们始终遵循血压不受控制的患者的每月访视指南，而以推广为重点的临床医生的比例为38%（p = .254）。在临床医生对预防关注度较高的患者中，30天内返回接受随访访视的未校正概率更高（p = 0.009），但在我们的校正模型中，在0.05显著性水平下没有证据。这些发现提供了一些有限的证据，RFT是一个有用的框架，以了解临床医生遵守HTN治疗指南。
Roughly half of the adults in the United States are diagnosed with hypertension (HTN). Unfortunately, less than one‐third have their condition under control. Clinicians generally have positive regard for the use of HTN guidelines to achieve HTN treatment goals; however, actual uptake remains low. Factors underpinning clinician variation in practice are poorly understood. To understand the relationship between clinicians’ personal motivation to complete goals and their uptake of the Joint National Commission's HTN guidelines. The authors used Regulatory Focus Theory (RFT, ie, prevention and promotion focus), an empirically supported motivational theory, as a guiding framework to examine the relationship. The authors hypothesized that clinicians with high prevention focus would report following guidelines more often and have shorter follow‐up visit intervals for patients with uncontrolled blood pressure. Clinicians (n = 27) caring for adult patients diagnosed with HTN (n = 8605) in Federally Qualified Health Centers (n = 8). Clinicians’ prevention and promotion focus scores and the number of days between visits for their patients with uncontrolled systolic blood pressure (SBP) (≥ 140 mm Hg). Consistent with RFT, 60% of prevention focused clinicians reported they always followed the monthly visit guideline for the patients with uncontrolled blood pressure, compared with 38% of promotion focused clinicians (p = .254). The unadjusted probability of returning for a follow‐up visit within 30 days was greater among patients whose clinician was higher in prevention focus (p = .009), but there was no evidence at the 0.05 significance level in our adjusted model. These findings provide some limited evidence that RFT is a useful framework to understand clinician adherence to HTN treatment guidelines.
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影响因子：
3.7
作者：
Cook, David A.;Pencille, Laurie J.;Wilkinson, John M.
通讯作者：
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影响因子：
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作者：
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DOI：
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发表时间：
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作者：
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