دورية أكاديمية
Implementation of the clinical practice guideline for individuals with amputations in Colombia: a qualitative study on perceived barriers and facilitators.
| العنوان: | Implementation of the clinical practice guideline for individuals with amputations in Colombia: a qualitative study on perceived barriers and facilitators. |
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| المؤلفون: | Patiño-Lugo DF; Facultad de Medicina, Universidad de Antioquia, Grupo de investigación en reahabilitación en salud, Carrera 51 D # 62-29 oficina MUA 302, Medellín, Colombia. felipe.patino@udea.edu.co., Pastor Durango MDP; Facultad de Medicina, Universidad de Antioquia, Grupo de investigación en reahabilitación en salud, Carrera 51 D # 62-29 oficina MUA 302, Medellín, Colombia., Lugo-Agudelo LH; Facultad de Medicina, Universidad de Antioquia, Grupo de investigación en reahabilitación en salud, Carrera 51 D # 62-29 oficina MUA 302, Medellín, Colombia., Posada Borrero AM; Facultad de Medicina, Universidad de Antioquia, Grupo de investigación en reahabilitación en salud, Carrera 51 D # 62-29 oficina MUA 302, Medellín, Colombia., Ciro Correa V; Facultad de Medicina, Universidad de Antioquia, Grupo de investigación en reahabilitación en salud, Carrera 51 D # 62-29 oficina MUA 302, Medellín, Colombia., Plata Contreras JA; Facultad de Medicina, Universidad de Antioquia, Grupo de investigación en reahabilitación en salud, Carrera 51 D # 62-29 oficina MUA 302, Medellín, Colombia., Vera Giraldo CY; Facultad de Medicina, Universidad de Antioquia, Grupo de investigación en reahabilitación en salud, Carrera 51 D # 62-29 oficina MUA 302, Medellín, Colombia., Aguirre-Acevedo DC; Facultad de Medicina, Universidad de Antioquia, Grupo de investigación en reahabilitación en salud, Carrera 51 D # 62-29 oficina MUA 302, Medellín, Colombia. |
| المصدر: | BMC health services research [BMC Health Serv Res] 2020 Jun 15; Vol. 20 (1), pp. 538. Date of Electronic Publication: 2020 Jun 15. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: London : BioMed Central, [2001- |
| مواضيع طبية MeSH: | Guideline Adherence*, Amputation, Surgical/*rehabilitation, Colombia ; Delivery of Health Care ; Female ; Health Personnel ; Humans ; Male ; Qualitative Research |
| مستخلص: | Background: The issue of lower extremity amputation has been in the Colombian political agenda for its relationship with the armed conflict and antipersonnel mines. In 2015 the Colombian Ministry of Health published a national clinical practice guideline (CPG) for amputee patients. However, there is a need to design implementation strategies that target end-users and the context in which the CPG will be used. This study aims to identify users' perceptions about the barriers and facilitators for implementing the guideline for the care of amputee patients in a middle-income country such as Colombia. Methods: Semi-structured interviews were conducted with 38 users, including patients, health workers, and administrative staff of institutions of the health system in Colombia. Individuals were purposively selected to ensure different perspectives, allowing a balance of individual positions. Results: According to participants' perceptions, barriers to implementation are classified as individual barriers (characteristics of the amputee patient and professionals), health system barriers (resource availability, timely care, information systems, service costs, and regulatory changes), and barriers related to clinical practice guidelines (utility, methodological rigour, implementation flexibility, and characteristics of the group developing the guidelines). Conclusions: Our study advances knowledge on the perceived individual and health system barriers and facilitators for the implementation of the CPG for amputee patients in Colombia. Importantly, the governance, financial, and service delivery arrangements of the Colombian health system are determining factors in implementing CPGs. For example, the financial arrangements between the insurance companies and the health care provider institutions were identified as barriers for the implementation of recommendations related to the continuity and opportunity of care of patients with amputations. The design of implementation strategies that successfully address the individual behaviours and the contextual health systems arrangements may significantly impact the health care process for amputee patients in Colombia. |
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| معلومات مُعتمدة: | 111571149680 Departamento Administrativo de Ciencia, Tecnología e Innovación |
| فهرسة مساهمة: | Keywords: Barriers; Clinical practice guidelines; Colombia; Facilitators; Implementation; Qualitative research |
| تواريخ الأحداث: | Date Created: 20200617 Date Completed: 20201125 Latest Revision: 20221207 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC7296745 |
| DOI: | 10.1186/s12913-020-05406-z |
| PMID: | 32539755 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1472-6963 |
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| DOI: | 10.1186/s12913-020-05406-z |