A mixed-methods study on the barriers to the application of non-pharmacological prevention evidence for venous thromboembolism in multiple myeloma patients from the perspective of nurses
10.3760/cma.j.cn211501-20250305-00641
- VernacularTitle:护士视角下应用多发性骨髓瘤患者静脉血栓栓塞症非药物预防证据的障碍因素分析
- Author:
Xiaoping ZHANG
1
;
Ruo ZHUANG
;
Liangying CHEN
;
Liqun ZHU
;
Lijuan SUN
Author Information
1. 江苏大学附属医院血液科，镇江 212001
- Publication Type:Journal Article
- Keywords:
Multiple myeloma;
Venous thromboembolism;
Theoretical domains framework;
Obstacle factors;
Nursing care
- From:
Chinese Journal of Practical Nursing
2025;41(32):2501-2508
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the barriers to nurses applying the best evidence for non-pharmacologic prophylactic management of venous thromboembolism (VTE) in patients with multiple myeloma (MM), and to provide a basis for the development of clinical responses.Methods:A parallel mixed-methods study was conducted in January 2024 to facilitate the selection of nurses from the hematology department of Affiliated Hospital of Jiangsu University to conduct semi-structured in-depth interviews. Concurrently, convenience sampling was employed to select nursing staff from the same departineat for a quantitative questionnaire survey. The interview outlines based on the theoretical domains framework and the questionnaires based on the Barriers to the Application of the Evidence and Facilitators Scale. The questionnaire was developed based on the Barriers and Facilitators to Evidence Application Scale and combined with qualitative and quantitative analyses to derive barriers to nurses' implementation of best evidence.Results:The qualitative study conducted interviews with 9 female nurses in the hematology department, aged 25-49. The quantitative study surveyed 17 female nurses in the hematology department with an average age of (33.18 ± 9.09) years. Nurses scored high overall in evidence application (156.65 ± 20.09) points, with high scores on the organizational form dimension (34.47 ± 1.48) points, the evidence application leader dimension (44.24 ± 1.30) points, the nurses' team dimension (42.53 ± 1.41) points, and the implementation scenario dimension (11.18 ± 0.61) points, which suggests that nurses were process was well supported overall. Low scores on the evidence dimension (11.94 ± 0.91) points and patient dimension (12.41 ± 1.03) points indicated that nurses had barriers in knowledge acquisition and practical application. The results of qualitative interviews further revealed that nurses encourter multiple challenges when applying best evidence, including insufficient knowledge base, low professional identity within societym, absence of standardized departmental protocols, negative outcome expectations, and inadequate motivation coupled with ulcear objectives.Conclusions:There are multiple clinical factors affecting nurses' application of best evidence, and departments should propose targeted coping strategies based on the barrier factors to ensure the successful implementation of evidence-based practice changes, and thus advance the clinical application of best evidence for non-pharmacological prevention of VTE in MM patients.
