Post on 30-May-2018
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ACTION RESEARCH
A USEFUL METHOD OF
PROMOTING CHANGE IN
PRIMARY CARE
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PRESENTED BY :1. Arif Winarno
2. Bambang Wicaksono
3. Budi Antomi
4. Endy Kurniawan
5. Nur Wahid
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CONTENT
1. Introduction
2. Background
3. Objective4. Discussion
5. Method
6. Result
7. Conclusion
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INTRODUCTION
The quality of care provided in health services is nolonger taken for granted. In order to improve healthcare, methods of changing doctors behavior havebeen explored, and so far there appear to be no easy
solution. In education, industry, and more recently, in nursing,
action research has been used to facilitate changeand improve the service provided. It is also to b agood method of bridging the gap between research
and practice. However, there are few publishedexamples of action research being used to improveprimary health care.
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The aim of this paper is to discus the benefits and
difficulties of using action research in primary care
using our research as an example. In order to do this,
we have outlined the range of methods used in our
study and have provided an overview of the results.
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Background
Action research has been used successfully
to promote change in disciplines other thanmedicine, but there are few examples of its
use in primary care.
Objective
We aimed to discuss the benefits and
difficulties of using action research inprimary care using the example of child
health surveillance provision in general
practice.
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DISCUSSION If the data generated from the practice meetings and
the interviews with health visitors and GPs areconsidered, using an action research model toinvolve primary health care staff in the research
process was succesful In term of the spectrum of action research
methodology, the study was more experimentalthan empoweringor more technicalthanemancipatory. The researcher designed the
project and pre-determined its time table andoutcome measures
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Although this study was at
experiment/technical end of the
action research spectrum, thehealth visitors involved thought
the process had been useful in
enabling them to reflect on andchange their provision of child
health surveillance
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METHOD Twenty-eight general practices were randomly allocated into two
groups. Action research was used to promote change in 14
practices by facilitating practice meetings and by providing
written feedback.
The other 14 practices received written feedback alone. The two
groups of practices were compared using the following: (i) semi-
structured interviews with one health visitor and GP from each
practice; (ii) observation of baby clinics; (iii) questionnaires to
parents; and (iv) return rates of child health surveillance reviews
from the personal child health record.
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RESULT
All 14 practices in the action research arm of the
study met as individual practice teams and
decided to make changes to their provision of
child health surveillance. Ten practices auditedtheir child health surveillance as a result. More
health visitors in the action research practices
than in the comparison practices reported
changes to child health surveillance, audit,communication and use of the personal child
health record.
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The majority of health visitors and GPs
thought involvement in the action
research process was beneficial.
However, we were unable to show astatistically significant difference
between the two groups of practices in
baby clinic provision, parentsatisfaction or the return rate of child
health surveillance reviews.
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CONCLUSION
Our study suggests that action research is asuccessful method of promoting change inprimary care. However, measuring the impactof change is difficult. There continues to be a
need for research on improving quality ofcare in health and quantitative technique willbe required. Action research can besuccessful method for investigating andimprovement in health care. We conclude that
using action research to involve primary careteams in the evaluation of service provisionpromotes teamwork, decision making, audit,and change
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