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首页> 外文期刊>Trials >Developing a complex intervention whilst considering implementation: the TANDEM (Tailored intervention for ANxiety and DEpression Management) intervention for patients with chronic obstructive pulmonary disease (COPD)
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Developing a complex intervention whilst considering implementation: the TANDEM (Tailored intervention for ANxiety and DEpression Management) intervention for patients with chronic obstructive pulmonary disease (COPD)

机译：考虑到实施情况，开发复杂的干预：对慢性阻塞性肺病（COPD）的患者进行串联（定制干预焦虑和抑郁症管理）干预患者

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Guidelines now call for a thorough and comprehensive description of the development of healthcare interventions to aid evaluation and understanding of the processes of change. This was the primary aim of this study but we also recognised that effective interventions are commonly not implemented in clinical practice. It is suggested that insufficient attention is given to the implementation process at the development phase of interventions. This study outlines the 5 step iterative process we adopted for considering both implementation and effectiveness issues from the outset of intervention development. We use the development of a complex intervention Tailored intervention for ANxiety and DEpression Management (TANDEM) in patients with chronic obstructive pulmonary disease to illustrate this process. Intervention development built upon the Medical Research Council framework for developing complex interventions and the person-based approach for development of behavioural interventions. Building an expert team, specifying theory, qualitative data collection and pre-piloting were all critical steps in our intervention development and are described here. Contact with experts in the field, and explicitly building on previous work, ensured efficiency of design. Qualitative work suggested guiding principles for the intervention such as introducing mood in relation to breathlessness, and providing flexible tailoring to patients’ needs, whilst implementation principles focused on training selected respiratory professionals and requiring supervision to ensure standards of care. Subsequent steps of intervention development, pre-piloting and intervention refinement led to an intervention that was deemed acceptable and if successful will be ready for implementation. The TANDEM study was developed efficiently by building on previous work and considering implementation issues from the outset, with the aim that if shown to be effective it will have more rapid translation in to the health care system with accelerated patient benefits. ISRCTN ISRCTN59537391 . Registered on 20 March 2017. Protocol version 6.0, 22 April 2018.
机译：准则现在呼吁彻底和全面描述的医疗保健干预措施，以帮助评估和了解变革过程。这是本研究的主要目的，但我们还认识到，有效的干预措施通常在临床实践中尚未实施。建议在干预措施的开发阶段对实施过程不足。本研究概述了我们采取的5步迭代过程，以考虑干预开发的一开始就考虑实施和有效性问题。我们利用慢性阻塞性肺病患者的焦虑和抑郁管理（串联）的复杂干预定制干预的发展，以说明这一过程。建立在医学研究委员会制定复杂干预措施的框架的干预发展和基于人的行为干预措施的方法。构建专家团队，指定理论，定性数据收集和预先策划是我们的干预开发中的所有关键步骤，并在此描述。与现场专家联系，并明确建立以前的工作，确保设计效率。定性工作提出了引导干预的指导原则，如引入与呼吸困难的情绪，并为患者的需求提供灵活的剪裁，而实施原则专注于培训选定的呼吸专业人士并要求监督以确保护理标准。干预开发的后续步骤，预先选择和干预细化导致了被视为可接受的干预，如果成功将准备实施。通过在以前的工作中建立并考虑开始的实施问题，有效地开发了串联研究，目的是，如果显示有效，它将在加速患者益处的卫生保健系统中更快地翻译。 ISRCTN ISRCTN59537391。 2017年3月20日注册。议定书版6.0，2018年4月22日。

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