实施和评估以患者为中心的慢性肾脏疾病电子健康干预的研究方案

Maoliosa Donald, Heather Beanlands, Sharon Straus, Lori Harwood, Gwen Herrington, Blair Waldvogel, Maria Delgado, Dwight Sparkes, Paul Watson, Meghan Elliott, Kerry McBrien, Aminu Bello, Brenda Hemmelgarn
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引用次数: 4

摘要

慢性肾脏疾病(CKD)的自我管理可以减缓疾病进展;然而,很少有工具可用于支持早期CKD患者。My kidney My Health是由患者和护理人员开发的以患者为中心的电子健康(eHealth)自我管理工具。本研究将调查“我的肾脏,我的健康”在初级保健和普通肾脏科诊所的实施情况。本研究旨在:(1)识别和解决可能影响网站在常规临床护理中的实施和可持续性的障碍和促进因素;(2)评估实施质量,为推广和扩大提供信息。我们会采用多阶段的方法,以质素实施架构为指引,并采用质素内容分析方法。首先,我们将根据准备思维工具和长期成功工具,通过与临床医生的访谈,确定实施的障碍和促进因素,以及可持续性的考虑因素。分析将以《实施研究综合框架》和《理论领域框架》为指导。将使用实施变更的专家建议汇编确定适当的实施策略,并根据Proctor的建议和“行动、行动者、背景、目标、时间”框架制定实施计划。最后,我们将探讨在RE-AIM框架指导下的实施质量。除了采用量身定制的实施策略来促进采用和可持续性外,文献中关于在临床护理中实施和维持以患者为中心的自我管理工具的系统方法的描述有限。我们的目标是深入了解如何将“我的肾脏我的健康”整合到临床护理中,以及如何在临床环境中更大规模地持续使用以患者为中心的电子健康工具。补充资料:在线版本包含补充资料,下载地址:10.1007/s43477-022-00038-3。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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A Research Protocol for Implementation and Evaluation of a Patient-Focused eHealth Intervention for Chronic Kidney Disease.

Self-management in chronic kidney disease (CKD) can slow disease progression; however, there are few tools available to support patients with early CKD. My Kidneys My Health is a patient-focused electronic health (eHealth) self-management tool developed by patients and caregivers. This study will investigate the implementation of My Kidneys My Health across primary care and general nephrology clinics. The study aims to: (1) identify and address barriers and facilitators that may impact implementation and sustainability of the website into routine clinical care; (2) evaluate implementation quality to inform spread and scale-up. We will conduct a multi-stage approach using qualitative methods, guided by the Quality Implementation Framework and using a qualitative content analysis approach. First, we will identify perceived barriers and facilitators to implementation and considerations for sustainability through interviews with clinicians, based on the Readiness Thinking Tool and the Long Term Success Tool. Analysis will be guided by the Consolidated Framework for Implementation Research and the Theoretical Domains Framework. Appropriate implementation strategies will be identified using the Expert Recommendations for Implementing Change compilation, and implementation plans will be developed based on Proctor's recommendations and the Action, Actor, Context, Target, Time framework. Finally, we will explore implementation quality guided by the RE-AIM framework. There is limited literature describing systematic approaches to implementing and sustaining patient-focused self-management tools into clinical care, in addition to employing tailored implementation strategies to promote adoption and sustainability. We aim to generate insights on how My Kidneys My Health can be integrated into clinical care and how to sustain use of patient-centric eHealth tools in clinical settings on a larger scale.

Supplementary information: The online version contains supplementary material available at 10.1007/s43477-022-00038-3.

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