{"id":8467,"date":"2023-11-29T11:30:35","date_gmt":"2023-11-29T09:30:35","guid":{"rendered":"https:\/\/www.easistent.ro\/?p=8467"},"modified":"2023-12-21T13:13:35","modified_gmt":"2023-12-21T11:13:35","slug":"prezentarea-generala-a-cadrului-jbi-de-implementare-a-dovezilor-in-practica-clinica","status":"publish","type":"post","link":"https:\/\/www.easistent.ro\/?p=8467","title":{"rendered":"Prezentarea general\u0103 a Cadrului JBI de implementare a dovezilor \u00een practica clinic\u0103"},"content":{"rendered":"\n<p>\u00cen articolul din septembrie am prezentat <strong>Modelul JBI de Practici bazate pe dovezi<\/strong>, orientat pe urm\u0103toarele patru direc\u021bii esen\u021biale \u00een vederea <em>realiz\u0103rii s\u0103n\u0103t\u0103\u021bii globale<\/em>: (1) generarea, (2) sinteza, (3) transferul \u0219i (4) implementarea dovezilor. \u00cen acest context, <strong>procesul de<\/strong> <strong>implementare a dovezilor<\/strong> era descris ca \u201e<em>un set de activit\u0103\u021bi inten\u021bionate care s\u0103 permit\u0103 interac\u021biunea stakeholderilor cheie cu dovezile de cercetare pentru a informa luarea deciziilor la punctul de \u00eengrijire \u0219i pentru a genera \u00eembun\u0103t\u0103\u021biri sus\u021binute \u00een calitatea furniz\u0103rii \u00eengrijirilor medicale<\/em>\u201d [1].<\/p>\n\n\n\n<p>\u00cen acest articol vom aduce o privire de ansamblu asupra <strong>Cadrului JBI de implementare a dovezilor \u00een practica clinic\u0103 (Fig. 1)<\/strong>,&nbsp; dezvoltat \u00een anul 2020, \u00een scopul ghid\u0103rii etap\u0103 cu etap\u0103 a acestui proces la punctul de \u00eengrijire.<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large is-resized\"><a href=\"https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2023\/11\/jbi1.png\"><img src=\"https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2023\/11\/jbi1-1024x422.png\" alt=\"\" class=\"wp-image-8443\" width=\"850\" srcset=\"https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2023\/11\/jbi1-1024x422.png 1024w, https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2023\/11\/jbi1-300x124.png 300w, https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2023\/11\/jbi1-768x316.png 768w, https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2023\/11\/jbi1.png 1054w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/a><figcaption>Fig. 1. Cadrul JBI de implementare a dovezilor &#8211; de la teorie la practic\u0103 <a>[2]<\/a><\/figcaption><\/figure><\/div>\n\n\n\n<p>Proiectele de implementare a dovezilor reprezint\u0103 ini\u021biative clinice, de echip\u0103, orientate pe \u00eembun\u0103t\u0103\u021birea calit\u0103\u021bii serviciilor medicale \u00een toate mediile de \u00eengrijire, indiferent de tipul acestora (unit\u0103\u021bi medicale sau puncte de \u00eengrijire din comunitate). Abordarea JBI este similar\u0103 cu abordarea tridimensional\u0103 a lui Donabetian (structur\u0103, proces \u0219i rezultat \u2013 Figura 2) sau a lui Deming (ciclul PDSA de \u00eembun\u0103t\u0103\u021bire a calit\u0103\u021bii \u2013 Figura 3).<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large is-resized\"><a href=\"https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2023\/11\/jbi2.png\"><img src=\"https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2023\/11\/jbi2.png\" alt=\"\" class=\"wp-image-8444\" width=\"850\" srcset=\"https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2023\/11\/jbi2.png 696w, https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2023\/11\/jbi2-300x89.png 300w\" sizes=\"(max-width: 696px) 100vw, 696px\" \/><\/a><figcaption>Fig. 2. Modelul de \u00eembun\u0103t\u0103\u021bire a calit\u0103\u021bii dezvoltat de Donabetian (2005) [3, 4]<\/figcaption><\/figure><\/div>\n\n\n\n<p>Ciclul PDSA (Plan-Do-Study-Act) este un proces sistematic de \u00eembun\u0103t\u0103\u021bire a calit\u0103\u021bii prin intermediul \u00eenv\u0103\u021b\u0103rii \u0219i adapt\u0103rii continue a produselor \/ proceselor \/ serviciilor, \u00een baza cuno\u0219tin\u021belor valoroase ob\u021binute \u00een timpul derul\u0103rii proiectului. Modelul este cunoscut \u0219i sub denumirea de <em>Roata Deming<\/em> sau <em>Ciclul Deming<\/em> \u0219i a fost dezvoltat \u00een 1993 prin adaptarea Ciclului PDCA al lui Walter Shewhart.<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large is-resized\"><a href=\"https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2023\/11\/jbi3.png\"><img src=\"https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2023\/11\/jbi3.png\" alt=\"\" class=\"wp-image-8445\" width=\"500\" srcset=\"https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2023\/11\/jbi3.png 429w, https:\/\/www.easistent.ro\/new\/wp-content\/uploads\/2023\/11\/jbi3-300x243.png 300w\" sizes=\"(max-width: 429px) 100vw, 429px\" \/><\/a><figcaption>Fig. 3. Ciclul PDSA a lui Deming adaptat Cadrului JBI de implementare a dovezilor [6]<\/figcaption><\/figure><\/div>\n\n\n\n<p>Revenind la <strong>Modelul JBI de implementare a dovezilor \u00een practica clinic\u0103<\/strong>, este necesar s\u0103 men\u021bion\u0103m c\u0103 el prezint\u0103 urm\u0103toarele dou\u0103 caracteristici importante: <strong>integreaz\u0103 teoriile de \u00eembun\u0103t\u0103\u021bire a calit\u0103\u021bii <\/strong>(prezentate anterior) \u0219i <strong>este orientat pe dou\u0103 direc\u021bii cheie<\/strong>: (1) coordonarea schimb\u0103rii \u00een practica clinic\u0103 (leadership clinic) \u0219i (2) ob\u021binerea schimb\u0103rii \u00een conformitate cu cele mai bune dovezi (rezultat al schimb\u0103rii).<\/p>\n\n\n\n<h2>1. <strong>Coordonarea schimb\u0103rii \u00een practica clinic\u0103<\/strong><\/h2>\n\n\n\n<p>Modelul JBI de implementare a dovezilor recunoa\u0219te importan\u021ba gener\u0103rii \u0219i sintezei de dovezi incluse \u00een sinteze sistematice (systematic reviews), ghiduri de practic\u0103 clinic\u0103 de \u00eencredere \u0219i \u00een alte resurse bazate pe dovezi (JBI evidence summary) \u0219i este concentrat \u00een mod prioritar pe procesul de implementare a acestor dovezi \u00een politicile de s\u0103n\u0103tate \u0219i \u00een practica clinic\u0103 (\u0219tiin\u021ba implement\u0103rii). \u0218tiin\u021ba implement\u0103rii reprezint\u0103 <em>\u201estudiul \u0219tiin\u021bific al metodelor de promovare a adopt\u0103rii sistematice a rezultatelor cercet\u0103rii \u0219i a altor practici bazate pe dovezi \u00een practica de rutin\u0103, \u00een scopul \u00eembun\u0103t\u0103\u021birii calit\u0103\u021bii \u0219i eficacit\u0103\u021bii serviciilor de s\u0103n\u0103tate\u201d<\/em> [7]. Acest domeniu relativ nou al \u0219tiin\u021bei a ap\u0103rut din necesitatea de a aborda provoc\u0103rile asociate implement\u0103rii cercet\u0103rii \u00een practic\u0103. \u00cen literatura de specialitate [8] au fost identificate trei tipuri de provoc\u0103ri \u00een ceea ce prive\u0219te implementarea dovezilor \u00een practica clinic\u0103:<\/p>\n\n\n\n<ul><li><strong>Provoc\u0103ri legate de sistem<\/strong> &#8211; includ caracteristicile contextului \u00een care este furnizat\u0103 \u00eengrijirea:<ul><li>mediul clinic: timp disponibil, volumul de munc\u0103, fluxul de lucru, fluctua\u021bia de personal;<\/li><li>cultur\u0103: atitudinea fa\u021b\u0103 de schimbare, angajament, motiva\u021bie, roluri, \u00eencredere;<\/li><li>procese de comunicare, reglement\u0103ri legislative \u0219i alte cerin\u021be externe: sistem de raportare, diverse standarde \u0219i linii directoare.<\/li><\/ul><\/li><li><strong>Provoc\u0103ri legate de personal<\/strong> \u2013 includ caracteristicele personalului implicat \u00een schimbare:<ul><li>nivel de angajare \u00een procesul de schimbare;<\/li><li>atitudine;<\/li><li>grad de \u00eencredere, \u00een\u021belegere \u0219i con\u0219tientizare;<\/li><li>nivel de cuno\u0219tin\u021be;<\/li><li>abilit\u0103\u021bi \u0219i aptitudini.<\/li><\/ul><\/li><li><strong>Provoc\u0103ri legate de interven\u021bie <\/strong>\u2013 includ caracteristicile interven\u021biei care determin\u0103 schimbarea:<ul><li>u\u0219urin\u021ba integr\u0103rii (grad de complexitate, costuri \u0219i resurse);<\/li><li>validitatea bazei de dovezi;<\/li><li>nivel de securitate;<\/li><li>preocup\u0103ri morale, etice \u0219i deontologice;<\/li><li>nevoi de formare profesional\u0103 \u0219i educa\u021bie medical\u0103 continu\u0103;<\/li><li>marketing \u0219i grad de con\u0219tientizare.<\/li><\/ul><\/li><\/ul>\n\n\n\n<p>\u00cen acest context, \u0219tiin\u021ba implement\u0103rii sus\u021bine \u0219i ghideaz\u0103 profesioni\u0219tii din domeniul s\u0103n\u0103t\u0103\u021bii \u00een identificarea: (a) barierelor \u00een implementare, (b) facilitatorilor implement\u0103rii \u0219i a (c) strategiilor adecvate de limitare a acestor provoc\u0103ri, \u00een scopul \u00eembun\u0103t\u0103\u021birii calit\u0103\u021bii \u00eengrijirilor medicale \u0219i men\u021binerii sustenabile a rezultatelor implement\u0103rii. Prin urmare, <strong>procesul de implementare<\/strong> reprezint\u0103 <em>\u201etotalitatea metodelor de promovare a adopt\u0103rii sistematice a rezultatelor cercet\u0103rii clinice \u0219i a altor practici bazate pe dovezi \u00een practica de rutin\u0103\u201d<\/em> [7].<\/p>\n\n\n\n<p>\u00cen procesul de schimbare a practicii clinice \u00een baza celor mai bune dovezi, <strong>analiza contextului<\/strong> este un prim pas strategic \u00een \u00een\u021belegerea problemelor locale care pot influen\u021ba schimbarea propus\u0103. Un rol important \u00een acest proces \u00eel are facilitarea. Aceasta reprezint\u0103 <em>\u201etehnica prin care o persoan\u0103 face lucrurile mai u\u0219oare pentru ceilal\u021bi\u201d<\/em> [9]. \u00cens\u0103, <strong>facilitarea<\/strong> <strong>sprijin\u0103 schimbarea<\/strong> \u00een cadrul organiza\u021biei, doar \u00een condi\u021biile \u00een care personalul implicat \u00een ini\u021bierea schimb\u0103rii de\u021bine:<\/p>\n\n\n\n<ul><li>Abilit\u0103\u021bile de leadership \u0219i facilitare necesare, inclusiv capacitatea de a elabora un plan \u0219i un scop.<\/li><li>Informa\u021biile adecvate cu privire la: context, schimbare \u0219i rezultatele a\u0219teptate.<\/li><li>Motiva\u021bia \u0219i capacitatea de a convinge pe ceilal\u021bi cu privire la necesitatea (avantajele) schimb\u0103rii.<\/li><li>Sprijinul necesar din partea managementului organiza\u021biei \u0219i al colegilor implica\u021bi \u00een schimbare (stakholderii cheie).<\/li><li>Abilit\u0103\u021bile adecvate de coordonare a lucrului \u00een echip\u0103, fiind recunoscut faptul c\u0103 procesul de implementare este o munc\u0103 \u00een echip\u0103.<\/li><\/ul>\n\n\n\n<p>Un alt rol important \u00een calea schimb\u0103rii \u00eel are <strong>evaluarea<\/strong>. Aceasta reprezint\u0103 <em>\u201ecolectarea sistematic\u0103 a informa\u021biilor cu privire la activit\u0103\u021bile, caracteristicile \u0219i rezultatele programului \/ serviciilor \/ politicii \/ proceselor, pentru a formula concluzii cu privire la programul \/ procesul respectiv, pentru a \u00eembun\u0103t\u0103\u021bi eficacitatea serviciilor \u0219i \/ sau pentru a informa deciziile cu privire la ac\u021biunile viitoare.\u201d<\/em> [10].<\/p>\n\n\n\n<h2>2. <strong>Ob\u021binerea schimb\u0103rii \u00een conformitate cu cele mai bune dovezi.<\/strong><\/h2>\n\n\n\n<p>Implementarea dovezilor are la baz\u0103 urm\u0103toarele activit\u0103\u021bi:<\/p>\n\n\n\n<ul><li><strong>Auditul clinic ini\u021bial \u2013 <\/strong>reprezint\u0103 <em>procesul sistematic de \u00eembun\u0103t\u0103\u021bire a \u00eengrijirii pacientului \u0219i a rezultatelor \u00eengrijirii (\u00eembun\u0103t\u0103\u021birea calit\u0103\u021bii serviciilor medicale) prin analizarea sistematic\u0103 a \u00eengrijirii \u00een func\u021bie de criterii de audit elaborate \u00een baza celor mai bune dovezi disponibile <\/em>[11].<\/li><li><strong>Feedback-ul <\/strong>\u2013 reprezint\u0103 <em>un instrument util de monitorizare continu\u0103 \u0219i conducere a implement\u0103rii schimb\u0103rii.<\/em> \u00cenainte de a ini\u021bia schimbarea, este necesar s\u0103 se compare practica actual\u0103 cu cele mai bune practici, folosind constat\u0103rile din auditul ini\u021bial. Aceste constat\u0103ri (at\u00e2t bune, c\u00e2t \u0219i mai pu\u021bin bune) trebuie prezentate personalului implicat \u00een proiect \u0219i grupului de lucru care supravegheaz\u0103 proiectul. Feedback-ul poate fi furnizat at\u00e2t verbal, c\u00e2t \u0219i \u00een scris, la nivel individual sau de grup [12].<\/li><li><strong>Identificarea \u0219i gestionarea barierelor \u00een calea schimb\u0103rii<\/strong> \u2013 are loc \u00een baza metodei JBI de schimbare a practicii, Getting Research into Practice (metoda GRiP) [2]. Aceast\u0103 metod\u0103 faciliteaz\u0103:<ul><li>analiza constat\u0103rilor auditului ini\u021bial;<\/li><li>identificarea barierelor \u00een calea implement\u0103rii schimb\u0103rii;<\/li><li>identificarea factorilor (facilitatorilor) care contribuie la utilizarea dovezilor;<\/li><li>dezvoltarea strategiilor de implementare care s\u0103 contribuie la reducerea decalajului dintre dovezi \u0219i practic\u0103.<\/li><\/ul><\/li><li><strong>Reevaluarea practicii dup\u0103 implementarea schimb\u0103rii printr-un audit clinic de urm\u0103rire<\/strong> \u2013 reprezint\u0103 o activitate esen\u021bial\u0103 a proiectului de implementare, \u00een scopul identific\u0103rii gradului de complian\u021b\u0103 al profesioni\u0219tilor cu criteriile de audit dezvoltate \u00een baza celor mai bune dovezi. Examinarea atent\u0103 a rezultatelor \u0219i discu\u021biile \u00een cadrul echipei de implementare cu privire la ac\u021biunile viitoare sunt de asemenea esen\u021biale [13].<\/li><\/ul>\n\n\n\n<p>\u00cen plus, ob\u021binerea schimb\u0103rii \u00een conformitate cu cele mai bune dovezi este un proces complex, care include urm\u0103toarele etape distincte:<\/p>\n\n\n\n<ul><li>Identificarea domeniului de practic\u0103 clinic\u0103 care necesit\u0103 \u00eembun\u0103t\u0103\u021bire;<\/li><li>Angajarea agen\u021bilor de schimbare;<\/li><li>Evaluarea contextului \u0219i disponibilit\u0103\u021bii pentru schimbare;<\/li><li>Revizuirea practicii \u00een raport cu criteriile de audit;<\/li><li>Implementarea modific\u0103rilor \u00een practic\u0103 folosind cadrul GRiP;<\/li><li>Reevaluarea practicii utiliz\u00e2nd un audit de urm\u0103rire;<\/li><li>Luarea \u00een considerare a sustenabilit\u0103\u021bii proiectului.<\/li><\/ul>\n\n\n\n<p>Acest aspect necesit\u0103 o abordare aprofundat\u0103, motiv pentru care, va fi dezvoltat \u00een articolul viitor.<\/p>\n\n\n\n<p><strong>Autor: <\/strong>Mariana Zazu \u2013 Specialist \u00een Dezvoltare Organiza\u021bional\u0103, OAMGMAMR Filiala Bucure\u0219ti; Director adjunct al Centrului Rom\u00e2n de Cercetare \u00een \u00cengrijiri de S\u0103n\u0103tate: Centru de Excelen\u021b\u0103 JBI<\/p>\n\n\n\n<p><strong>Surse de documentare:<\/strong><\/p>\n\n\n\n<p>[1] Jordan Z, Lockwood C, Aromataris E, Munn Z. The updated JBI model of Evidencebased Healthcare: A model reconsidered. Adelide, Australia: The Joanna Briggs Institute. 2016.<\/p>\n\n\n\n<p><a>[2] <\/a>Porritt K, McArthur A, Lockwood C, Munn Z (Editors). JBI Handbook for Evidence Implementation. JBI, 2020. <a href=\"https:\/\/doi.org\/10.46658\/JBIMEI-20-01\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/doi.org\/10.46658\/JBIMEI-20-01<\/a><\/p>\n\n\n\n<p>[3] Donabedian, A. Evaluating the Quality of Medical Care, The Milbank Quarterly. 2005. 83(4):691-729<\/p>\n\n\n\n<p>[4] England, N. H. S., and N. H. S. Improvement. A model for measuring quality care. 2022. <a href=\"https:\/\/www.england.nhs.uk\/wp-content\/uploads\/2022\/02\/qsir-measuring-quality-care.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.england.nhs.uk\/wp-content\/uploads\/2022\/02\/qsir-measuring-quality-care.pdf<\/a><\/p>\n\n\n\n<p>[5] Moen RD, Norman CL. Clearing up myths about the Deming cycle and seeing how it keeps evolving. 2010. <a href=\"http:\/\/www.apiweb.org\/circling-back.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">http:\/\/www.apiweb.org\/circling-back.pdf<\/a><\/p>\n\n\n\n<p>[6] Porritt K, McArthur A, Lockwood C, Munn Z (Editors). JBI Handbook for Evidence Implementation. JBI, 2020. Available from: <a href=\"https:\/\/implementationmanual.jbi.global\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/implementationmanual.jbi.global<\/a>. <a href=\"https:\/\/doi.org\/10.46658\/JBIMEI-20-01\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/doi.org\/10.46658\/JBIMEI-20-01<\/a>\u00a0<\/p>\n\n\n\n<p>[7] Eccles, M.P., Mittman, B.S. Welcome to Implementation Science . Implementation Sci 1, 1 (2006). <a href=\"https:\/\/doi.org\/10.1186\/1748-5908-1-1\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/doi.org\/10.1186\/1748-5908-1-1<\/a><\/p>\n\n\n\n<p>[8] Geerligs L, Rankin NM, Shepherd HL, Butow P. Hospital-based interventions: a systematic review of staff-reported barriers and facilitators to implementation processes. Implement Sci. 2018 Feb 23;13(1):36. doi: 10.1186\/s13012-018-0726-9. PMID: 29475440; PMCID: PMC5824580.<\/p>\n\n\n\n<p>[9] Jordan Z, Lockwood C, Munn Z, Aromataris E. The updated Joanna Briggs Institute Model of Evidence-Based Healthcare. Int J Evid Based Healthc. 2019 Mar;17(1):58-71. doi: 10.1097\/XEB.0000000000000155. PMID: 30256247.<\/p>\n\n\n\n<p>[10] Harvey, G., Kitson, A. PARIHS revisited: from heuristic to integrated framework for the successful implementation of knowledge into practice. Implementation Sci 11, 33 (2015). <a href=\"https:\/\/doi.org\/10.1186\/s13012-016-0398-2\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/doi.org\/10.1186\/s13012-016-0398-2<\/a><\/p>\n\n\n\n<p><a>[11] <\/a>Hart, AR 2002, Principles for best practice in clinical audit, National Institute for Clinical Excellence, Radcliffe Medical Press, Oxon, United Kingdom.<\/p>\n\n\n\n<p>[12] Cooke, LJ, Duncan, D, Rivera, L, Dowling, SK, Symonds, C &amp; Armson, H 2018, How do physicians behave when they participate in audit and feedback activities in a group with their peers?, Implement Sci, vol. 13, no. 1, p. 104.<\/p>\n\n\n\n<p>[13] Pearson, A, Field, J &amp; Jordan, Z 2009,Evidence-Based Clinical Practice in Nursing and Health Care: Assimilating Research, Experience and Expertise, Blackwell Publishing.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u00cen articolul din septembrie am prezentat Modelul JBI de Practici bazate pe dovezi, orientat pe urm\u0103toarele patru direc\u021bii esen\u021biale \u00een vederea realiz\u0103rii s\u0103n\u0103t\u0103\u021bii globale: (1) generarea, (2) sinteza, (3) transferul \u0219i (4) implementarea dovezilor. \u00cen acest context, procesul de implementare a dovezilor era descris ca \u201eun set de activit\u0103\u021bi inten\u021bionate care s\u0103 permit\u0103 interac\u021biunea stakeholderilor [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":8443,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[152,155],"tags":[],"_links":{"self":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/8467"}],"collection":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=8467"}],"version-history":[{"count":2,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/8467\/revisions"}],"predecessor-version":[{"id":8469,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/posts\/8467\/revisions\/8469"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=\/wp\/v2\/media\/8443"}],"wp:attachment":[{"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=8467"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=8467"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.easistent.ro\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=8467"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}