Neurosurgeons' experiences of conducting and disseminating clinical research in low-income and middle-income countries: a reflexive thematic analysis.

Autor:	Whiffin CJ; University of Cambridge, NIHR Global Health Research Group on Neurotrauma, Cambridge, UK c.whiffin@derby.ac.uk.; College of Health Psychology and Social Care, University of Derby, Derby, UK., Smith BG; University of Cambridge, NIHR Global Health Research Group on Neurotrauma, Cambridge, UK.; Department of Clinical Neurosciences, Division of Neurosurgery, Addenbrooke's Hospital, Cambridge, UK., Esene IN; University of Cambridge, NIHR Global Health Research Group on Neurotrauma, Cambridge, UK.; Neurosurgery Division, Faculty of Health Sciences, University of Bamenda, Bambili, NW Region, Cameroon., Karekezi C; Department of Neurosurgery, Rwanda Military Hospital, Kigali, Kigali City, Rwanda.; Young Neurosurgeons Committee, World Federation of Neurosurgical Societies, Nyon, Switzerland., Bashford T; University of Cambridge, NIHR Global Health Research Group on Neurotrauma, Cambridge, UK.; Department of Clinical Neurosciences, Division of Neurosurgery, Addenbrooke's Hospital, Cambridge, UK., Mukhtar Khan M; Young Neurosurgeons Committee, World Federation of Neurosurgical Societies, Nyon, Switzerland.; Neurosurgery, Northwest School of Medicine, Northwest General Hospital & Research Center, Peshawar, Khyber Pakhtunkhwa, Pakistan., Hutchinson PJ; University of Cambridge, NIHR Global Health Research Group on Neurotrauma, Cambridge, UK.; Department of Clinical Neurosciences, Division of Neurosurgery, Addenbrooke's Hospital, Cambridge, UK., Kolias AG; University of Cambridge, NIHR Global Health Research Group on Neurotrauma, Cambridge, UK.; Department of Clinical Neurosciences, Division of Neurosurgery, Addenbrooke's Hospital, Cambridge, UK., Fontoura Solla DJ; Department of Neurology, Division of Neurosurgery, University of Sao Paulo, Sao Paulo, Brazil., Paiva WS; University of Cambridge, NIHR Global Health Research Group on Neurotrauma, Cambridge, UK.; Department of Neurology, Division of Neurosurgery, University of Sao Paulo, Sao Paulo, Brazil., Figaji A; University of Cambridge, NIHR Global Health Research Group on Neurotrauma, Cambridge, UK.; Division of Neurosurgery, Red Cross Children's Hospital & University of Cape Town, Cape Town, South Africa.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2021 Sep 22; Vol. 11 (9), pp. e051806. Date of Electronic Publication: 2021 Sep 22.
DOI:	10.1136/bmjopen-2021-051806
Abstrakt:	Objectives: Low-income and-middle-income countries (LMICs) are increasing investment in research and development, yet there remains a paucity of neurotrauma research published by those in LMICs. The aim of this study was to understand neurosurgeons' experiences of, aspirations for, and ability to conduct and disseminate clinical research in LMICs. Design: This was a two-stage inductive qualitative study situated within the naturalistic paradigm. This study committed to an interpretivist way of knowing (epistemology), and considered reality subjective and multiple (ontology). Data collection used online methods and included a web-based survey tool for demographic data, an asynchronous online focus group and follow-up semistructured interviews. Data were analysed using Braun and Clarke's Reflexive Thematic Analysis supported by NVivo V.12. Setting: LMICs. Participants: In April-July 2020, 26 neurosurgeons from 11 LMICs participated in this study (n=24 in the focus groups, n=20 in follow-up interviews). Results: The analysis gave rise to five themes: The local landscape; creating capacity; reach and impact; collaborative inquiry; growth and sustainability. Each theme contained an inhibitor and stimulus to neurosurgeons conducting and disseminating clinical research, interpreted as 'the neurosurgical research potential in LMICs'. Mentorship, education, infrastructure, impact and engagement were identified as specific accelerators. Whereas lack of generalisability, absence of dissemination and dissemination without peer review may desensitise the impact of research conducted by neurosurgeons. Conclusion: The geographical, political and population complexities make research endeavour challenging for neurosurgeons in LMICs. Yet in spite of, and because of, these complexities LMICs provide rich opportunities to advance global neurosurgery. More studies are required to evaluate the specific effects of accelerators of research conducted by neurosurgeons and to understand the effects of desensitisers on high-quality, high-impact clinical research. Competing Interests: Competing interests: AGK and PJH are supported by the National Institute for Health Research (NIHR) Cambridge Biomedical Research Centre and the NIHR Global Health Research Group on Neurotrauma. PJH is also supported by a NIHR Research Professorship and the Royal College of Surgeons of England. The NIHR Global Health Research Group on Neurotrauma was commissioned by the United Kingdom NIHR using Official Development Assistance funding (Project No. 16/137/105). INE, CK, MMK, DJFS and AGK are members of the Young Neurosurgeons Committee of the World Federation of Neurosurgical Societies. The committee is supporting this project. (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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