Barriers to implementation of preoperative urostomy site marking in nurse-physician cooperation: A qualitative study based on the Theoretical Domains Framework

护士与医生合作实施术前尿路造口部位标记的障碍:基于理论领域框架的定性研究

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Abstract

OBJECTIVE: This study aimed to understand the barriers to nurse-physician collaboration in implementing preoperative stoma site marking using qualitative research methods following Theoretical Domain Framework. METHODS: A qualitative descriptive study using semi-structured interviews was conducted from March to June 2023 in the urology departments of nine tertiary hospitals in China. Twelve urologists and eight enterostomal therapists (ETs) were recruited using purposive sampling. Audio recordings were transcribed verbatim and data were analyzed using content analysis. RESULTS: Five themes were identified in the study: shortage of manpower and stoma care products, lack of standard and regulations, lack of motivation and intention, inconsistency of expectation on consequences, and difficulties in cooperation. CONCLUSION: This study indicated that the barriers to implementation of preoperative urostomy localization among urologists and ETs. Institutions, resources, clear career plans, and performance feedback can increase motivation and intention. In addition, the lack of cooperation between urologists and ETs is a key factor for poor urostomy localization implementation, which calls for effective and equal communication between doctors and nurses.

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