尼泊尔心血管疾病有效转诊面临的挑战:从卫生工作者和患者的角度进行的定性研究

IF 1.8 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiology Research and Practice Pub Date : 2024-03-05 DOI:10.1155/2024/5583709
Soniya Shrestha, Rashmi Maharjan, Swornim Bajracharya, Niharika Jha, Sushmita Mali, Bobby Thapa, Punya Shori Suwal, Dipanker Prajapati, Biraj Man Karmacharya, Archana Shrestha
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引用次数: 0

摘要

背景。尼泊尔目前正面临着非传染性疾病(NCDs)的沉重负担,其中包括心血管疾病(CVDs),它是该国死亡率最高的疾病,但尼泊尔似乎并没有适当的转诊策略。本研究探讨了影响尼泊尔心血管疾病病例转诊系统的各种因素和挑战。研究方法在这项定性研究中,我们对特意挑选的 57 名主要参与者进行了面对面访谈和电话访谈,其中包括来自巴格马蒂省的 35 名三级、二级和一级医疗保健专业人员,以及来自巴格马蒂省和马德西省的 22 名心血管疾病患者(心肌梗死和中风)。我们使用访谈指南对他们进行了访谈,访谈采用开放式问题,以当地语言在私密空间深入了解情况。我们对访谈进行了录音、逐字记录、编码,并采用主题方法进行了分析。结果调查结果表明,心血管疾病病例从初级保健到二级保健再到三级保健的转诊系统存在不足和功能失调。影响心血管病病例转诊的主要因素是心血管病专科服务集中在少数几个城市地区、各中心之间缺乏系统的沟通、自我转诊、缺乏心血管病护理方面的人力资源,以及由于地理和经济原因导致的病人转院障碍。结论尼泊尔缺乏心血管疾病患者转诊系统。了解并解决影响心血管疾病患者转诊系统的关键因素,有助于改善心脏治疗效果,最终挽救生命。
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Challenges in Effective Referral of Cardiovascular Diseases in Nepal: A Qualitative Study from Health Workers’ and Patients’ Perspective
Background. Nepal, currently facing a high burden of noncommunicable diseases (NCDs), including cardiovascular diseases (CVDs), which poses the highest mortality rate in the country, does not seem to have a proper referral strategy. This study explored the wide range of factors and challenges that affect the referral system of CVD cases in Nepal. Methods. In this qualitative study, we conducted face-to-face and telephone interviews with purposely selected 57 key participants which included 35 healthcare professionals from tertiary, secondary, and primary levels from Bagmati Province and 22 CVD patients (myocardial infarction and stroke) from Bagmati and Madhesh Provinces. We interviewed them using an interview guide with open-ended questions for in-depth information in a local language and in a private space. The interviews were audio-recorded, transcribed verbatim, coded, and analyzed using the thematic approach. Results. The findings indicated that the referral system for CVD cases from primary- to secondary- to tertiary-level care is inadequate and malfunctioning. The major factors affecting referral of CVD cases are centralization of CVD-specific services in few urban areas, inadequate systematic communication between the centers, self-referential, lack of human resources for CVD care, and obstacles to patient transfer due to geographical and financial reasons. Conclusion. A referral system for CVD patients is absent in the context of Nepal. Understanding and addressing key factors that affect the referral system of CVD patients may help to improve cardiac outcomes and ultimately save lives.
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来源期刊
Cardiology Research and Practice
Cardiology Research and Practice Medicine-Cardiology and Cardiovascular Medicine
CiteScore
4.40
自引率
0.00%
发文量
64
审稿时长
13 weeks
期刊介绍: Cardiology Research and Practice is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies that focus on the diagnosis and treatment of cardiovascular disease. The journal welcomes submissions related to systemic hypertension, arrhythmia, congestive heart failure, valvular heart disease, vascular disease, congenital heart disease, and cardiomyopathy.
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