探索初级保健医生在为高血压患者提供最佳护理时所面临的挑战:定性研究。

IF 3 Q1 PRIMARY HEALTH CARE Journal of Primary Care and Community Health Pub Date : 2024-01-01 DOI:10.1177/21501319241291466
Prawira Oka, Aminath Shiwaza Moosa, Chirk Jenn Ng
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引用次数: 0

摘要

背景:在全球范围内,大多数高血压患者的血压(BP)控制都不理想。多重障碍阻碍了初级保健医生(PCPs)对这些患者进行有效护理。本研究旨在探讨初级保健医生在为高血压患者提供最佳护理时所面临的挑战,重点是找出新的障碍:这项定性研究涉及新加坡 5 家初级保健诊所的 17 名初级保健医生。一名训练有素的研究人员使用主题指南进行了个人深度访谈。研究人员采用了有目的的抽样方法,以确保在达到数据饱和之前有足够的资历代表。访谈录音被逐字转录,并经过独立检查。使用 NVivo 对数据进行管理,并进行主题分析:新障碍分为患者、医生、药物和系统相关因素。患者因素包括偏好自然健康疗法和血液化验的不便。同时,医生在诊断和治疗各种血压表型和血压变化的患者时面临挑战。启动双重疗法是一个与药物有关的障碍。最后,系统因素包括电子病历(EMR)的布局不够理想,阻碍了有效的高血压管理:结论:需要采取多管齐下的方法来解决提供最佳高血压治疗的重大障碍。应通过教育增强患者的能力,尽量减少药物滴定带来的不便。此外,医生应更好地诊断和治疗血压表型更具挑战性的患者。最后,改善复方药片的使用和优化 EMR 将有助于改善对高血压患者的护理。
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Exploring the Challenges Faced by Primary Care Physicians in Providing Optimal Care for Patients With Hypertension: A Qualitative Study.

Background: Globally, most patients with hypertension have suboptimal blood pressure (BP) control. Multiple barriers prevent primary care physicians (PCPs) from effectively caring for these patients. This study aimed to explore the challenges faced by PCPs in providing optimal care for patients with hypertension, with a specific focus on identifying new barriers.

Methods: This qualitative study involved 17 PCPs across 5 primary care clinics in Singapore. A trained researcher conducted individual in-depth interviews using a topic guide. Purposive sampling was employed to ensure adequate representation of seniority until data saturation was achieved. The audio-recorded interviews were transcribed verbatim and independently checked. The data were managed using NVivo and thematic analysis was conducted.

Results: New barriers were divided into patient, physician, drug, and systemrelated factors. Patient factors included a preference for natural health remedies and the inconvenience of blood tests. Meanwhile, physicians faced challenges diagnosing and treating patients with various BP phenotypes and BP variability. The initiation of dual therapy was a drugrelated barrier. Finally, system factors included the suboptimal layout of the electronic medical records (EMR) that impeded effective hypertension management.

Conclusion: A multi-pronged approach is required to address the significant barriers to providing optimal hypertension care. Patients should be empowered through education and minimizing the inconvenience of medication titrations. Additionally, physicians should be better equipped to diagnose and treat patients with more challenging BP phenotypes. Finally, improved access to combination pills and an optimized EMR would contribute to improved care for patients with hypertension.

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来源期刊
CiteScore
4.80
自引率
2.80%
发文量
183
审稿时长
15 weeks
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