摘要
目的:开发一种用于调研北京大学第三医院医师头孢菌素皮试原因、可靠且可行的定量工具(调查问卷)。方法:结合客观能力、机会、主观动机-行为(COM-B)模型,采用定性研究方法,根据定性资料饱和原则,对方便抽样选取的医师进行半结构式访谈,了解医师头孢菌素皮试处方行为可能的影响因素;根据访谈结果开发定量工具(调查问卷),编制调查问卷初始版本。通过主观评价和客观检验2种方式完成问卷的质量检验和修订,制定正式问卷。结果:10名来自北京大学第三医院的医师参加了半结构化访谈。定性研究确定了3个影响医师头孢菌素皮试处方行为的主题,即能力、机会和动机因素。每个主题由若干个副主题组成,主题"能力因素"包括2个副主题:头孢菌素皮试预测价值认知情况和院内皮试相关文件知晓情况;主题"机会因素"包括4个副主题:科室常规"要求"或护士干预、患者意愿或要求、上级医师经验传授、皮试制度或指南缺乏;主题"动机因素"包括1个副主题:自我保护心理。基于访谈结果,采用7个副主题作为框架,进行调查问卷设计。基于专家建议和预调查填写反馈完成问卷的修改,制定正式问卷。结论:该研究运用定性研究方法从医师角度开发了一种可行的定量调查问卷,为后续开展定量研究探讨影响医师头孢菌素皮试处方行为的因素提供研究工具。
OBJECTIVE To develop a reliable and feasible quantitative tool(questionnaires)which exploring the causes of routine skin test for cephalosporin prescribing in Peking University Third Hospital.METHODS Combined with Capacity,Opportunity,Motivation-Behavior(COM-B)model,qualitative study methods were adopted.We conducted semi-structured interviews on the subjects selected by convenient sampling to learn about the possible influencing factors of physicians'prescription behavior of cephalosporin skin test according to the principle of saturation of qualitative data and developed a quantitative tool based on the results of preliminary qualitative study.The quality inspection and revision of the questionnaire were completed through two methods:subjective evaluation and objective inspection.RESULTS Ten physicians participated in the semi-structured interview.The results of the qualitative study identified three themes affecting the physicians'prescription behavior of cephalosporin skin test.Each theme consisted of several sub-themes.The theme"capacity factors"included 2 sub-themes:cognition of predictive value of cephalosporin skin test and knowledge of documents related to in-hospital skin test;the theme"opportunity factors"included 4 sub-themes:routine requirements of departments or nurse intervention,patient willingness or requirements,experience teaching of senior physicians and lack of skin test system or guidelines.The theme"motivation factors"included 1 sub-themes:psychology of self-protection.Based on the interview results,seven sub-themes were used as the framework to design the questionnaire.We completed the revision of the questionnaire and formulated a formal questionnaire according to expert suggestions and pre-survey feedback.CONCLUSION This study used qualitative research methods to develop a feasible quantitative questionnaire from the perspective of doctors,providing a research tool for the follow-up quantitative research to explore the factors affecting doctors'cephalosporin skin test prescription behavi
作者
应颖秋
宋茵茵
路明
帅瑗
李楠
杨丽
赵荣生
YING Yingqiu;SONG Yinyin;LU Ming;SHUAI Yuan;LI Nan;YANG Li;ZHAO Rongsheng(Department of Pharmacy,Peking University Third Hospital,Beijing 100191,China;Department of Respiratory and Critical Care Medicine,Peking University Third Hospital,Beijing 100191,China;Infectious Disease Center,Peking University Third Hospital,Beijing 100191,China;Clinical Epidemiology Research Center,Peking University Third Hospital,Beijing 100191,China;Department of Pharmacy Administration and Clinical Pharmacy,Pharmaceutical Science,Peking University,Beijing 100191,China)
出处
《中国医院药学杂志》
CAS
北大核心
2023年第16期1769-1774,共6页
Chinese Journal of Hospital Pharmacy
基金
国家重点研发计划课题项目(编号:2022YFC3401205)。
