Application of standard treatment guidelines in rural community health centres, Timor-Leste
Application of standard treatment guidelines in rural community health centres, Timor-Leste
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DOI：
10.1093/heapol/czr051
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发表时间：
2012-08-01
影响因子：
3.2
通讯作者：
Porter, John
中科院分区：
文献类型：
--
作者：
Higuchi, Michiyo;Okumura, Junko;Porter, John
目的分析护士和助产士对标准治疗指南（STG）的知识和态度，STG是为了帮助他们在东帝汶农村社区卫生中心（CHCs）的做法。数据进行了定性分析，使用的框架approach.Results总体而言，急性呼吸道感染，疟疾和腹泻的标准治疗是众所周知的受访者。临床护士表现出准确和详细的知识，尤其是抗生素的使用。受访者愿意使用STG，并认为他们“应该”遵循它们。产生这种感觉的原因是，她们既认识到自己是一线卫生工作者，同时又认识到自己是边缘公务员。对实行短期津贴所带来的变化给予了积极的评价。三个组成部分的变化进行了观察：概念，日常实践和感知病人的满意度。受访者以前感到缺乏信心，并希望提高他们作为卫生保健工作者的能力;他们通过使用STG对自己的做法充满信心。自信心在临床护士访谈中被更清楚地识别出来。被访者指出使用STG的困难很少，并提出了解决这些困难的方法。讨论通过使用STG，护士/助产士获得了知识和自信。对这些变化的积极看法促进了进一步利用STG。临床护士培训对STG的知识和态度有积极影响。在日常实践中应用STG的困难很少，这与以前针对西方世界医生的研究相反。在卫生政策框架内发展STG被认为是一个关键因素。STG存在于相互关联的相关政策和各种方案中。东帝汶的经验表明，短期补助金对于初级保健一级的非医生保健提供者很有价值。
Objective To analyse nurses' and midwives' knowledge of and attitudes towards standard treatment guidelines (STGs), which were developed to help their practices at rural community health centres (CHCs) in Timor-Leste.Methods Fifty-five nurses and midwives were individually interviewed. Data were analysed qualitatively using the Framework approach.Results Overall, the standard treatments for acute respiratory tract infections, malaria and diarrhoea were well known by the respondents. Clinical nurses showed precise and detailed knowledge, especially for antibiotic use. The respondents were willing to use STGs and believed that they 'should' follow them. This feeling arose due to their self-awareness as frontline health workers and, at the same time, as peripheral civil servants. The changes brought about by the introduction of STGs were positively perceived. Three components of the change were observed: the concept, daily practice and perceived patient satisfaction. The respondents had previously felt a lack of confidence and hoped to improve their capacity as health care workers; they became confident in their practices by using STGs. Self-confidence was identified more clearly in the clinical nurse interviews. Few difficulties in using STGs were indicated, and the respondents suggested ways to deal with these difficulties.Discussion By using the STGs, the nurses/midwives gained knowledge and self-confidence. The positive perception of the changes promoted further use of the STGs. Clinical nurse training positively influenced the knowledge of and attitudes towards the STGs. Few difficulties in applying STGs in daily practice were identified, which is contrary to previous studies that targeted physicians in the Western world. Development of STGs within a health policy framework was considered a key factor. The STGs exist across related policies and various programmes, which are interconnected. The Timor-Leste experience indicates the value of STGs for non-physician health care providers at the primary health care level.