Use of the Diffusion of Innovation Model in venous ulcers by specialized professionals

ABSTRACT Objective: To analyze the influence of the evidence and of the opinion of peers on the decisions of specialists regarding the agreement with recommendations for prevention and treatment of venous ulcer. Methods: This is a quasi-experimental study with two interventions: provision of studies with the evidence of the recommendations and provision of the opinion of peers, with sample of 73 specialized doctors and nurses. Delphi technique was used in the search for agreement, with three rounds. Results: The participants evaluated 82 recommendations organized into eight domains: evaluation of patient and wound; documentation of clinical findings; care with the wound and surrounding skin; indication of dressing; use of antibiotics; improvement of venous return and prevention of recurrence; referrals of patients; and professional training. The interventions resulted in statistically significant changes in four domains. Conclusion: The interventions were able to change the opinion of participants, leading them to agreement regarding the recommendations, regardless of the level of evidence.

摘要
研究目的：探析证据与同行意见对专科医师就静脉溃疡（venous ulcer）防治推荐方案达成共识的决策影响。
研究方法：本研究为类实验研究（quasi-experimental study），设置两项干预措施：提供支撑推荐方案的循证研究资料，以及提供同行评议意见；研究样本涵盖73名专科医师与护理人员。本研究采用德尔菲法（Delphi technique）开展共识征询，共进行三轮轮次。
研究结果：参与人员共评估82条推荐方案，涵盖8个维度：患者与创面评估、临床检查结果记录、创面及周围皮肤护理、敷料使用指征、抗生素应用、静脉回流改善与复发预防、患者转诊及专业培训。两项干预措施在4个维度上产生了具有统计学意义的显著改变。
研究结论：两项干预措施均可改变参与者的决策倾向，使其与相关推荐方案达成共识，且该效果不受证据等级高低的影响。