Barriers and Facilitators of Implementation of Benefit Finding Promotion Program in Maintenance Hemodialysis Patients Based on the i-PARIHS Framework

Abstract

Background Improving the level of benefit finding can help alleviate the high prevalence of negative emotional problems and promote mental health in maintenance hemodialysis (MHD) patients, so the research group has constructed a benefit finding promotion program for MHD patients based on the PERMA flourish model in the earlier stage, which is urgently needed to be applied in clinical practice. Objective To explore the barriers and facilitators to the implementation of benefit finding promotion program for MHD patients, and provide reference for psychological intervention of them. Methods Using purposive sampling method, 12 healthcare workers and 9 MHD patients in the hemodialysis unit of the Second Affiliated Hospital of the Naval Medical University were selected as the study subjects from March to May 2023, and semi-structured interviews were conducted with them using the phenomenological research method, and the results of the interviews were analyzed in terms of the three dimensions of change, change recipients, and the organizational environment based on the i-PARIHS framework, and the responses to the obstacle factors were developed. Results Barriers to the application of the program at the change level include lack of detail, high professionalism, and cultural differences in the program content; at the recipient level include cognitive differences in the team, lack of psychosocial training for healthcare workers, low motivation of patients to participate, and inconsistent acceptance; at the organizational environment level, the lack of incentives in the ward, and the lack of a suitable place for the intervention. Factors facilitating the implementation of the program include, on the change side, interventions derived from high-quality research, richness and variety of program content, etc., on the receiver side, strong support from the ward leadership, positive cooperation from team members, etc., and on the organizational environment side, the ward has a certain base of psychological interventions, and changes are in line with national and health policies. Conclusion The application of benifit finding promotion program for MHD patients is affected by a variety of factors, the need to comprehensively analyze the barriers and facilitators, and to take specific action strategies to promote the program to the ground, so that it is orderly and efficient in the clinical implementation of the application.

Keywords

• dialysis|benefit finding|promoting action on research implementation in health services integrated framework|barriers|facilitators|semi-structured interviews|qualitative research