Determining the research priorities for emergency care within the Western Cape province of South Africa: A consensus study

IF 1.4 4区 医学 Q3 EMERGENCY MEDICINE African Journal of Emergency Medicine Pub Date : 2023-12-03 DOI:10.1016/j.afjem.2023.11.007
Robert Holliman, Lee Wallis, Colleen Saunders
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Abstract

Introduction

Low- and middle-income countries (LMICs) are disproportionally affected by conditions requiring emergency care but there are limited contextually appropriate studies performed within these settings involving the patient population and healthcare systems they aim to benefit. Over the past five years, researchers in the Western Cape of South Africa have produced approximately 20 % of all emergency care publications from Africa, yet no agreed list of research priorities exists. Establishing research priorities, via recognised consensus methods, can ensure that efforts and resources in LMICs are more appropriately targeted to the need.

Method

Using a modified Delphi study, we invited a range of public and private representatives from different professional emergency care cadres within the Western Cape to identify current evidence gaps and consensus research priorities across the four areas of the WHO Emergency Care Systems framework: scene care, prehospital care, facility-based care, and the emergency care system itself. We then purposively selected eleven experts holding key academic and management positions to form a panel and perform a nominal group technique process to discuss these identified research priorities and establish a final list of priority research questions.

Result

Forty of the sixty-six (61 %) emergency care professionals invited contributed to the Delphi phase of the study, with representation from all professional cadres. After deduplication, 154 research topics were identified in the first round. In the second round, 94 (61 %) topics were considered research priorities by at least 80 % of participants. Following the nominal group technique discussion, 26 questions were established as consensus research priorities having been ranked as a top ten priority by over 50 % of panellists.

Conclusion

We were able to successfully collate expert opinion and identify existing emergency care knowledge gaps within the Western Cape province of South Africa. Key topics identified for future work included questions on current health-seeking behaviour, dispatch, interfacility transfer, and staff burnout.

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确定南非西开普省紧急护理的研究重点:一项共识研究
低收入和中等收入国家(LMICs)受到需要紧急护理的疾病的影响不成比例,但在这些环境中开展的涉及患者群体和旨在受益的卫生保健系统的适合环境的研究有限。在过去的五年中,南非西开普省的研究人员发表了大约20%的非洲急诊出版物,但没有一致同意的研究重点清单。通过公认的共识方法确定研究重点,可以确保中低收入国家的努力和资源更适当地针对需求。方法采用改进的德尔菲研究,我们邀请了来自西开普省不同专业急救干部的一系列公共和私营代表,以确定当前的证据差距和共识研究重点,涉及世卫组织急救系统框架的四个领域:现场护理、院前护理、基于设施的护理和急救系统本身。然后,我们有目的地选择了11位担任重要学术和管理职位的专家组成一个小组,并执行名义上的小组技术过程来讨论这些确定的研究重点,并建立最终的优先研究问题清单。结果邀请的66名急救专业人员中有40名(61%)参与了德尔菲阶段的研究,他们都是专业干部。在重复数据删除后,第一轮确定了154个研究课题。在第二轮中,至少有80%的参与者认为94个(61%)主题是研究重点。在名义上的小组技术讨论之后,超过50%的小组成员将26个问题列为十大优先事项,并建立了共识研究优先事项。结论:我们能够成功地整理专家意见,并确定南非西开普省现有的急诊护理知识差距。确定的未来工作的关键主题包括目前的求医行为、派遣、机构间转移和工作人员倦怠等问题。
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来源期刊
CiteScore
2.40
自引率
7.70%
发文量
78
审稿时长
85 days
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