First-aid training for primary Healthcare providers on a remote Island: a mixed-methods study.


Journal

BMC medical education
ISSN: 1472-6920
Titre abrégé: BMC Med Educ
Pays: England
ID NLM: 101088679

Informations de publication

Date de publication:
23 Jul 2024
Historique:
received: 11 09 2023
accepted: 11 07 2024
medline: 24 7 2024
pubmed: 24 7 2024
entrez: 23 7 2024
Statut: epublish

Résumé

Ensuring ongoing first-aid training for primary healthcare providers (PHPs) is one of the critical strategies for providing quality health services and contributing to achieving universal health coverage. However, PHPs have received insufficient attention in terms of training and capacity building, especially in the remote areas of low-to-middle-income countries. This study evaluated the effectiveness of a first-aid training program for PHPs on a Vietnamese island and explored their perspectives and experiences regarding first-aid implementation. A mixed-methods study was conducted among 39 PHPs working in community healthcare centers. The quantitative method utilized a quasi-experimental design to evaluate participants' first-aid knowledge at three time points: pre-training, immediately post-training, and three months post-training. Sixteen of the PHPs participated in subsequent semi-structured focus group interviews using the qualitative method. Quantitative data were analyzed using repeated measures analysis of variance (ANOVA), while qualitative data were subjected to thematic analysis. The quantitative results showed a significant improvement in both the overall mean first-aid knowledge scores and the subdimensions of the first-aid knowledge scores among healthcare providers post-training. There was a statistically significant difference between the baseline and immediate posttest and follow-up knowledge scores (p < 0.001). However, the difference in knowledge scores between the immediate posttest and three-month follow-up was not significant (p > 0.05). Three main themes emerged from the focus group discussions: perception of first-aid in remote areas, facilitators and barriers. Participants identified barriers, including infrastructure limitations, shortage of the primary healthcare workforce, inadequate competencies, and insufficient resources. Conversely, receiving considerable support from colleagues and the benefits of communication technologies in implementing first aid were mentioned as facilitators. The training bolstered the participants' confidence in their first-aid responses, and there was a desire for continued education. Implementing periodic first-aid refresher training for PHPs in a nationwide resource-limited setting can contribute significantly to achieving universal health coverage goals. This approach potentially enhances the preparedness of healthcare providers in these areas to deliver timely and effective first aid during emergencies, which may lead to more consistent primary healthcare services despite various challenges.

Sections du résumé

BACKGROUND BACKGROUND
Ensuring ongoing first-aid training for primary healthcare providers (PHPs) is one of the critical strategies for providing quality health services and contributing to achieving universal health coverage. However, PHPs have received insufficient attention in terms of training and capacity building, especially in the remote areas of low-to-middle-income countries. This study evaluated the effectiveness of a first-aid training program for PHPs on a Vietnamese island and explored their perspectives and experiences regarding first-aid implementation.
METHODS METHODS
A mixed-methods study was conducted among 39 PHPs working in community healthcare centers. The quantitative method utilized a quasi-experimental design to evaluate participants' first-aid knowledge at three time points: pre-training, immediately post-training, and three months post-training. Sixteen of the PHPs participated in subsequent semi-structured focus group interviews using the qualitative method. Quantitative data were analyzed using repeated measures analysis of variance (ANOVA), while qualitative data were subjected to thematic analysis.
RESULTS RESULTS
The quantitative results showed a significant improvement in both the overall mean first-aid knowledge scores and the subdimensions of the first-aid knowledge scores among healthcare providers post-training. There was a statistically significant difference between the baseline and immediate posttest and follow-up knowledge scores (p < 0.001). However, the difference in knowledge scores between the immediate posttest and three-month follow-up was not significant (p > 0.05). Three main themes emerged from the focus group discussions: perception of first-aid in remote areas, facilitators and barriers. Participants identified barriers, including infrastructure limitations, shortage of the primary healthcare workforce, inadequate competencies, and insufficient resources. Conversely, receiving considerable support from colleagues and the benefits of communication technologies in implementing first aid were mentioned as facilitators. The training bolstered the participants' confidence in their first-aid responses, and there was a desire for continued education.
CONCLUSIONS CONCLUSIONS
Implementing periodic first-aid refresher training for PHPs in a nationwide resource-limited setting can contribute significantly to achieving universal health coverage goals. This approach potentially enhances the preparedness of healthcare providers in these areas to deliver timely and effective first aid during emergencies, which may lead to more consistent primary healthcare services despite various challenges.

Identifiants

pubmed: 39044192
doi: 10.1186/s12909-024-05768-6
pii: 10.1186/s12909-024-05768-6
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

790

Informations de copyright

© 2024. The Author(s).

Références

WHO. Regional Office for the Western Pacific. Universal health coverage: moving towards better health: action framework for the Western Pacific Region. WHO Regional Office for the Western Pacific. 2016. https://apps.who.int/iris/handle/10665/246420 Accessed 3 January 2023.
WHO. Universal Health Coverage. https://www.who.int/health-topics/universal-health-coverage#tab=tab_2 . Accessed 3 January 2023.
WHO. Primary Health Care. https://www.who.int/news-room/fact-sheets/detail/primary-health-care . Accessed 20 January 2023.
WHO. Building the primary health care workforce of the 21st century. https://www.who.int/docs/default-source/primary-health-care-conference/workforce.pdf . Accessed 20 January 2023.
Giang PN, Kelly M, Nhung NTT, Sarma H. Continuing medical education programs for primary care physicians from remote locations of Vietnam: a needs assessment. BMC Med Educ. 2022;22(1):279.
doi: 10.1186/s12909-022-03336-4
Cheng TM. Vietnam’s health care system emphasizes prevention and pursues universal coverage. Health Aff. 2014;33(11):2057–63.
doi: 10.1377/hlthaff.2014.1141
Ministry of Health. Joint Anual Health Review 2015: Strengthening primary health care at the grassroots towards universal health coverage. Medical Publish House Hanoi. 2016.
Vietnam Ministry of Health. Circular No. 39/2017/TT-BYT dated on October 18, 2017 on Health on basic package of health services applied to grassroots health facilities (in Vietnamese). Thông tư quy định gói dịch vụ y tế cơ bản cho tuyến y tế cơ sở. 2017.
Hoa NT, Derese A, Peersman W, Markuns JF, Willems S, Tam NM. Primary care quality in Vietnam. Perceptions and opinions of primary care physicians in commune health centers - a mixed-methods study. PLoS ONE. 2020;15(10):e0241311.
doi: 10.1371/journal.pone.0241311
Kien VD, Van Minh H, Giang KB, Dao A, Tuan LT, Ng N. Socioeconomic inequalities in catastrophic health expenditure and impoverishment associated with non-communicable diseases in urban Hanoi, Vietnam. Int J Equity Health. 2016;15(1):169.
doi: 10.1186/s12939-016-0460-3
Chien TTT, Troedsson H, Trong DQ, et al. Policy options for the renovation and improvement of the health system towards equity, effciency and development. Hanoi: Medical Publishing House; 2007.
WHO. Primary health care and health emergencies: Brief. https://www.who.int/docs/default-source/primary-health-care-conference/emergencies.pdf . Accessed 13 January 2023.
Minna S, Leena H, Tommi K. How to evaluate first aid skills after training: a systematic review. Scand J Trauma Resusc Emerg Med. 2022;30(1):56.
doi: 10.1186/s13049-022-01043-z
Abella BS. High-quality cardiopulmonary resuscitation: current and future directions. Curr Opin Crit Care. 2016;22(3):218–24.
doi: 10.1097/MCC.0000000000000296
Chen K-Y, Ko Y-C, Hsieh M-J, Chiang W-C, Ma MH-M. Interventions to improve the quality of bystander cardiopulmonary resuscitation: a systematic review. PLoS ONE. 2019;14(2):e0211792.
doi: 10.1371/journal.pone.0211792
Riggs M, Franklin R, Saylany L. Associations between cardiopulmonary resuscitation (CPR) knowledge, self-efficacy, training history and willingness to perform CPR and CPR psychomotor skills: a systematic review. Resuscitation. 2019;138:259–72.
doi: 10.1016/j.resuscitation.2019.03.019
Song J, Guo W, Lu X, Kang X, Song Y, Gong D. The effect of bystander cardiopulmonary resuscitation on the survival of out-of-hospital cardiac arrests: a systematic review and meta-analysis. Scand J Trauma Resusc Emerg Med. 2018;26(1):86.
doi: 10.1186/s13049-018-0552-8
Bakke HK, Wisborg T. We need to include bystander first aid in trauma research. Scand J Trauma Resusc Emerg Med. 2017;25(1):32.
doi: 10.1186/s13049-017-0372-2
Goolsby C, Rojas L, Moore K, et al. Layperson ability and willingness to Use Hemostatic dressings: a Randomized, Controlled Trial. Prehospital Emerg Care. 2019;23(6):795–801.
doi: 10.1080/10903127.2019.1593566
Goolsby CA, Strauss-Riggs K, Klimczak V, et al. Brief, web-based Education Improves Lay Rescuer Application of a Tourniquet to Control Life-threatening bleeding. AEM Educ Train. 2018;2(2):154–61.
doi: 10.1002/aet2.10093
Goralnick E, Chaudhary MA, McCarty JC, Caterson EJ, et al. Effectiveness of Instructional Interventions for Hemorrhage Control Readiness for Laypersons in the Public Access and Tourniquet Training Study (PATTS): a Randomized Clinical Trial. JAMA Surg. 2018;153(9):791–9.
doi: 10.1001/jamasurg.2018.1099
Olumide AO, Asuzu MC, Kale OO. Effect of First Aid Education on First Aid Knowledge and skills of Commercial drivers in South West Nigeria. Prehosp Disaster Med. 2015;30(6):579–85.
doi: 10.1017/S1049023X15005282
von Bertalanffy. Ludwig. An outline of General System Theory. The British Journal for the philosophy of Science. The British Society for the Philosophy of Science. Volume 1. Oxford University Press; 1950. pp. 134–65. 2.
McEwan M, Wills EM. Theoretical basis for nursing. 6 ed. th ed. Lippincott Williams & Wilkins; 2022.
Elo S, Kyngas H. The qualitative content analysis process. J Adv Nurs. 2008;62(1):107–15.
doi: 10.1111/j.1365-2648.2007.04569.x
Shahrakivahed A, Masinaienezhad N, Shahdadi H, Arbabisarjou A, Asadibidmeshki E, Heydari M. The Effect of CPR Workshop on the Nurses’ Level of Knowledge and Skill. Int Archives Med 2015;8.
van den Bos-Boon A, Hekman S, Houmes R-J, et al. Effectiveness of Simulation Training and Assessment of PICU nurses’ resuscitation skills: a mixed methods study from the Netherlands. J Pediatr Nurs. 2021;59:e52–60.
doi: 10.1016/j.pedn.2021.01.029
Thompson ME, Harutyunyan TL, Dorian AH. A first aid training course for primary health care providers in Nagorno Karabagh: assessing knowledge retention. Prehosp Disaster Med. 2012;27(6):509–14.
doi: 10.1017/S1049023X1200132X
Li F, Sheng X, Zhang J, et al. Effects of pediatric first aid training on preschool teachers: a longitudinal cohort study in China. BMC Pediatr. 2014;14:209.
doi: 10.1186/1471-2431-14-209
Li F, et al. Effects of three different first-aid training methods on knowledge retention of caregivers and teachers: a randomized and longitudinal cohort study in China. Public Health. 2020;178:97–104.
doi: 10.1016/j.puhe.2019.08.021
Bitton A, Fifield J, Ratcliffe H, et al. Primary healthcare system performance in low-income and middle-income countries: a scoping review of the evidence from 2010 to 2017. BMJ Glob Health. 2019;4 Suppl 8:e001551.
doi: 10.1136/bmjgh-2019-001551
Ministry of Health. Decision to promulgate a plan to protect, care for and improve people’s health until 2025. 2023. Bộ Y Tế. Quyết định ban hành kế hoạch bảo về, chăm sóc và nâng cao sức khỏe nhân dân đến năm 2025. 2023 (In Vietnamese).
Hoa NT, Tam NM, Derese A, Markuns JF, Peersman W. Patient experiences of primary care quality amongst different types of health care facilities in central Vietnam. BMC Health Serv Res. 2019;19(1):275.
doi: 10.1186/s12913-019-4089-y
Acharya B, Tenpa J, Thapa P, Gauchan B, Citrin D, Ekstrand M. Recommendations from primary care providers for integrating mental health in a primary care system in rural Nepal. BMC Health Serv Res. 2016;16:492.
doi: 10.1186/s12913-016-1768-9
Jaeger FN, Bechir M, Harouna M, Moto DD, Utzinger J. Challenges and opportunities for healthcare workers in a rural district of Chad. BMC Health Serv Res. 2018;18(1):7.
doi: 10.1186/s12913-017-2799-6
Courtenay M, Nancarrow S, Dawson D. Interprofessional teamwork in the trauma setting: a scoping review. Hum Resour Health. 2013;11:57.
doi: 10.1186/1478-4491-11-57
McCulloch P, Rathbone J, Catchpole K. Interventions to improve teamwork and communications among healthcare staff. Br J Surg. 2011;98(4):469–79.
doi: 10.1002/bjs.7434
Nancarrow SA, Booth A, Ariss S, Smith T, Enderby P, Roots A. Ten principles of good interdisciplinary team work. Hum Resour Health. 2013;11:19.
doi: 10.1186/1478-4491-11-19
Farahat TM, Hegazy NN, Mowafy M. Information and communication technologies in primary healthcare facilities in Egypt. Prim Health Care Res Dev. 2018;19(1):88–95.
doi: 10.1017/S1463423617000470
Pędziński B, Sowa P, Kołpak M, Pędziński W, Szpak AS. The use of electronic medical records in primary health care in the Podlaskie Voivodeship. Zdrowie Publiczne. 2013;123:107–11.
Tonetto LM, Saurin TA, Fogliatto FS, Tortorella GL, Narayanamurthy G, da Rosa VM, Tengkawan J. Information and communication technologies in emergency care services for patients with COVID-19: a multi-national study. Int J Prod Res. 2021;1–17.
Registered Nurses’ Association of Ontario. Healthy WorkEnvironments Best Practice Guidelines. Registered Nurses’ Asso-ciation of Ontario, Ontario. Retrieved from http://www.rnao.orgon 11 August 2006.
O’Brien-Pallas L, Tomblin Murphy G, White S, Hayes L, Baumann A, Higgin A, Pringle D, Birch S, McGillis Hall L, Kephart G, Wang S. Building the future:an integrated strategy for nursing human resources in Canada. Ottawa: Nursing Sector Study Corporation; 2005.
Hughes E. Nurses’ perceptions of continuing professionaldevelopment. Nurs Standard. 2015;19(43):41–9.
Nolan M, Owens RG, Curran M, Venables A. Recon-ceptualising the outcomes of continuing professional development. Int J Nurs Stud. 2000;37:457–67.
doi: 10.1016/S0020-7489(00)00025-0
Upenieks V. Recruitment and retention strategies: a magnethospital prevention model.Nursing Economics 2003; 21(1), 7–19.

Auteurs

Ninh Do Thi (N)

College of Nursing, Ewha Womans University, Seoul, Korea. dtninh90@gmail.com.
Hai Phong University of Medicine and Pharmacy, 72 Nguyen Binh Khiem, Hai Phong, Vietnam. dtninh90@gmail.com.

Giang Hoang Thi (GH)

Hai Phong University of Medicine and Pharmacy, 72 Nguyen Binh Khiem, Hai Phong, Vietnam.

Yoonjung Lee (Y)

Department of Medical Education, Seoul National University College of Medicine, Seoul, Korea.

Khue Pham Minh (KP)

Hai Phong University of Medicine and Pharmacy, 72 Nguyen Binh Khiem, Hai Phong, Vietnam.

Hai Nguyen Thanh (HN)

Hai Phong University of Medicine and Pharmacy, 72 Nguyen Binh Khiem, Hai Phong, Vietnam.

Jwa-Seop Shin (JS)

Department of Medical Education, Seoul National University College of Medicine, Seoul, Korea.

Tuyen Luong Xuan (T)

Vietnam National Institute of Maritime Medicine, Hai Phong, Vietnam.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH