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目的:分析阻碍个体经营药店参与结核病控制的潜在因素。方法:实验于2005-07在重庆市区完成。调查主要采用了定性的方法,共调查了29名对象,采用方便抽样和滚雪球抽样的方法对15家经营时间1年以上的个体经营药店的管理人员或者工作人员进行了个人深入访谈;采用目的性抽样的方法对4名卫生监督所,药监局以及结核病防治所的相关官员及领导进行了关键人物访谈;采用专题小组访谈的形式,对2家结防专业机构的10名医护人员进行访谈。采用定性方法对采访对象进行了个人深入访谈、小组访谈、关键人物访谈。借助MAXqda软件,采用主体框架法进行分析。主要调查内容:①药店参与结核控制的现状,包括宣传结核病知识,发现、转诊结核病例。②药店参与结核病例发现的能力,包括员工的专业背景知识,对结核病知识的了解,接受新知识的机会。③药店参与结核病控制的客观阻碍因素,包括利益冲突、消费者的态度等。结果:29名受访对象均进入结果分析。①药店是患者接受健康教育的一个潜在的、重要的部门,绝大部分顾客在购药时都会咨询药店工作人员的意见,药店在发现以及转诊结核病患者中也起到一定促进作用,药店工作人员曾有发现结核病疑似患者并建议其接受医生治疗的经历。②药店从业人员仅了解部分结核病基础知识,缺少对结核病相关知识的知晓。但部分员工有医学或护理方面的专业背景,并且接受新知识的渠道也较多,如定期职能部门培训、电视以及报纸宣传等,但结核病知识的专题培训却相当少。③虽然绝大多数药店从业人员都认为推荐患者去结防所治疗不会对药店生意造成太大的影响,但也有部分人认为利益冲突会间接影响到药店参与结核病控制的行为。结论:药店在结核病控制工作中起到一定促进作用,但药店从业人员对结核病相关知识的了解有必要加强,采取一系列可行性措施解除这些阻碍因素,利益冲突会间接影响到药店参与结核病控制的行为。
OBJECTIVE: To analyze the underlying factors that prevent individual-run pharmacies from participating in tuberculosis control. Method: The experiment was completed in Chongqing area in 2005-07. The survey mainly adopted the qualitative method. A total of 29 subjects were surveyed. In-depth interviews were conducted with 15 managers or staff members of 15 self-employed pharmacies operating for more than 1 year by means of convenient sampling and snowball sampling. Sampling methods conducted key interviews with officials and leaders of the four health supervision offices, the Food and Drug Administration Office and the TB prevention and treatment center. In the form of panel interviews, 10 medical and nursing staff of two anti-tuberculosis and specialized agencies were interviewed. Qualitative methods were used to conduct personal in-depth interviews, group interviews and key interviews with interviewees. With the help of MAXqda software, the mainframe method is used for analysis. The main contents of the investigation: ① pharmacies to participate in tuberculosis control status, including the promotion of knowledge of tuberculosis, tuberculosis cases were found, referral. ② pharmacies involved in tuberculosis cases found that the ability, including staff professional background knowledge of tuberculosis knowledge, to accept new opportunities for knowledge. ③ pharmacy to participate in the objective obstruction of tuberculosis control factors, including conflicts of interest, consumer attitudes and so on. Results: All 29 respondents entered the result analysis. ① pharmacy is a potential and important part of the patient’s health education. Most of the customers consult the pharmacy staff when purchasing the medicine. The pharmacy also plays a role in the detection and referral of tuberculosis patients. The pharmacy work Personnel have been found in suspected TB patients and recommended that they receive medical treatment experience. ② pharmacy practitioners only understand some of the basic knowledge of tuberculosis, lack of awareness of tuberculosis-related knowledge. However, some staff have a professional background in medicine or nursing, and there are many channels for receiving new knowledge, such as regular training of functional departments, television and newspaper publicity, etc. However, the training on the topic of TB knowledge is relatively small. ③ Although most pharmacy practitioners think that recommending patients to the treatment of anti-tuberculosis treatment will not have too much impact on pharmacy business, some people think that the conflict of interest will indirectly affect the pharmacy’s participation in tuberculosis control. Conclusion: Pharmacies play a role in promoting tuberculosis control. However, practitioners in pharmacies need to know more about tuberculosis-related knowledge. A series of feasible measures should be taken to relieve these obstacles. Conflicts of interest will indirectly affect the participation of pharmacies in tuberculosis control behavior.