摘要
目的探讨医护人员实施骨质疏松性骨折后再骨折防治临床实践的障碍因素,为专家共识的实施及推进提供参考。方法采取描述性质性研究方法,基于能力、机会、动机-行为模型及理论域框架设置访谈提纲,对安徽省2所三级甲等综合医院14名骨科医护人员进行半结构访谈,采用内容分析法对访谈资料进行整理和分析。结果共提炼出3个主题及10个亚主题,包括受访者实施骨质疏松性骨折后再骨折防治行为的能力有限(专业知识、技能缺乏、决策优先级较后),缺乏外部支持(医疗和人力资源受限、协同管理机制及质量监管缺失、多学科合作存在壁垒、患者及其家庭支持欠缺),动力不足(受访者态度消极、职业认同差异、自信心不足、奖励机制缺失)。结论管理者应当聚焦于影响医护人员实施骨质疏松性骨折后再骨折防治的能力、机会及动机三大核心要素,设计并实施针对性的干预策略,以提升岗位胜任力,强化实施再骨折防治素养;营造外部支持环境,创造实施再骨折防治的机会;增强职业认同感,强化实施再骨折防治的动机,最终促进患者的康复。
Objective To explore the barriers to preventing and treating secondary fracture in patients with osteoporotic fractures in medical staff,and to provide reference for the implementation and promotion of expert consensus.Methods The interview outline was developed based on the Capability Opportunity Motivation and Behavior(COM-B)model and Theoretical Domains Framework,and a semi-structured interview was conducted in 14 orthopedic medical staff.The interview data were sorted out and analyzed by content analysis.Results Three main themes and ten sub-themes were identified,including limited implementation capacity(restricted pro⁃fessional knowledge and skills among respondents,and lower decision-making prioritization);insufficient external support(constraints in medical and human resources,absence of coordinated management mechanisms and quality supervision,barriers to multidisci⁃plinary collaboration,and lack of support from patients and their families),and inadequate motivation(negative attitudes among respon⁃dents,variations in professional identity,lack of self-confidence,and absence of reward mechanisms).Conclusion Hospital manag⁃ers should focus on three core elements-capability,opportunity,and motivation-that influence healthcare professionals'implementa⁃tion of secondary fracture prevention for osteoporotic fractures.To improve patient rehabilitation,targeted intervention strategies should be implemented to enhance professional competency and strengthen secondary fracture prevention literacy;create supportive environ⁃ment,and reinforce professional identity to boost motivation for secondary fracture prevention.
作者
祁金梅
施慧
张静
夏丽莉
申才良
QI Jinmei;SHI Hui;ZHANG Jing;XIA Lili;SHEN Cailiang(School of Nursing,Anhui University of Chinese Medicine,Hefei 230038,China;Dept.of Orthopedics,Jixi Road Campus,the First Affiliated Hospital of Anhui Medical University,Hefei 230032,China)
出处
《护理学报》
2025年第15期1-6,共6页
Journal of Nursing(China)
基金
国家重点研发计划课题(2022YFC2407504)。
关键词
COM-B模型
理论域框架
骨质疏松性骨折
再骨折防治
质性研究
COM-B model
theoretical domain framework
osteoporotic fractures
prevention and treatment of secondary fracture
qualitative research
