透析期间饮食管理最佳证据临床应用的障碍因素分析——基于CFIR理论OA

Objective To explore the obstacles to clinical use of the best evidence for dietary management during dialysis.Methods Under the theoretical guidance of the consolidated framework for implementation research(CFIR),an interview outline was drawn,according to which semi-structured interviews were conducted.Nurses were selected as research subjects,and Colaizzi's seven-step method was used to analyze the data.Results A total of 5 themes were generated,namely innovation,external factors,internal factors,individuals,and implementation process.In terms of innovation,there were 2 sub-themes:some evidence did not fully consider the clinical context,so it was not highly applicable;there was a lack of training in relevant knowledge,and nurses'knowledge was not updated timely.In terms of external factors,there was 1 sub-theme:social support was an important external force for changes.In terms of internal factors,there were 3 sub-themes:although the changes would increase the workload of nurses,the benefits outweighed the disadvantages;the process should be standardized,and health education materials were necessary;attention should be paid to maintaining a good relationship between nurses and patients to promote the smooth development of changes.In terms of the individual aspect,there were 2 sub-themes:nurses were highly determined to change,and middle managers played a key role in changes.In terms of the implementation process,there were 2 sub-themes:the main difficulty was the education of patients,and some evidence did not fully take patients'wishes into account.Conclusion It is necessary to develop a standardized dietary management process during dialysis,improve the systematic training mechanism,enrich health education materials,and fully consider the clinical context of the evidence and patients'wishes,so as to promote the clinical use of the best evidence for dietary management during dialysis.