Disseny, validació i posada en pràctica d’un instrument per a mesurar els coneixements teòrics dels professionals sanitaris en la mesura de la pressió arterial: qüestionari ARC

Serrat Costa, Mar
Introduction: Arterial hypertension (AHT) is the main risk factor in attributable mortality. It is therefore considered one of the most significant public health problems, in particular for primary health care, which is where it is diagnosed and most people with hypertension are monitored Professional health-care workers require special training and expertise from in order to diagnose AHT There was nothing in the literature consulted that included any assessment done using a validated tool (questionnaire) of healthcare professionals’ theoretical and practical knowledge in checking blood pressure. This doctoral thesis has several goals. The first is to design and validate a tool to assess theoretical knowledge and skills in blood pressure checks for initial AHT diagnoses. The second is to determine the level of knowledge of professionals and illustrate the factors that contribute to their variability. Methodology: Cross-cutting observational study in the field of primary healthcare. First of all, a knowledge questionnaire was designed, prepared, and validated in three languages (Catalan, Spanish, and English) following the Rasch-IRT method. Second, theoretical knowledge was assessed with a sample of 385 primary healthcare medical and nursing professionals, using an ARC questionnaire, where potential factors contributing to their variability were analyzed and practical skills in taking blood pressure evaluated under the Objective Structured Clinical Evaluation Technique (OSCE). Results: A theoretical knowledge questionnaire in initial AHT diagnoses was compiled and validated in three languages. Primary healthcare medical and nursing professionals in Girona, despite their own perceptions of possessing sufficient knowledge to make diagnoses and taking blood pressure, did not have sufficient knowledge and skills in diagnosing AHT. It should be noted that the professionals with some postgraduate and/or ongoing training in the last year in AHT performed better in the ARC knowledge questionnaire. Conclusions: This thesis offers an ARC questionnaire as a validated tool to make objective, uniform analyses of knowledge in initial AHT diagnoses made by medical and nursing professionals, comparing them over time and assessing the various strategies established to improve such knowledge. The results of this thesis highlight where there is insufficient knowledge to runn a high-quality clinical practice. To solve this problem, a type of ongoing training will be required which covers theory and practice and where professional healthcare workers can actively take part in this training ​
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