构建一个程序实施理论使用过程评估复杂的质量改善试验在养老院的程序实施理论
Liane R Ginsburg1, Adam Easterbrook2, Ariane Massie3
1School of Health Policy & Management, York University, Toronto, Ontario, Canada.
The Gerontologist
|June 1, 2023
概括
在长期护理 (LTC) 中实施复杂的干预措施需要了解上下文因素. 支持性的领导力显著提高了实施的忠实性,即使干预的可接受性很低.
科学领域:
- 老年学是一门学科.
- 医疗保健管理的管理
- 实施科学 实施科学
背景情况:
- 长期护理 (LTC) 面临着重大质量挑战.
- 由于实施障碍,复杂的干预措施往往取得有限的成功.
- 在LTC设置中实施干预的过程尚不清楚.
研究的目的:
- 开发一个程序理论,解释LTC中复杂干预的实施.
- 识别影响机制,情境影响和实施结果.
- 探索前线工作者如何实施干预措施并推动变革.
主要方法:
- 在住宅环境中为老年人提供更安全的护理 (SCOPE) 试验的同时过程评估.
- 混合方法探索性序列设计,利用接地理论和混合效应回归.
- 分析了定性数据,以开发实施的概念模型.
主要成果:
- 观察到适度的实施忠实度.
- 关键的促进者包括护理助手的参与,支持性的领导和角色感知转变.
- 领导层的支持是实施忠实性的最强有力的预测因素,无论干预措施的可接受性或感知效益如何.
结论:
- 开发的程序理论填补了在养老院干预实施中的关键知识缺口.
- 这些发现可以为扩大复杂干预措施的策略提供信息,并指导未来的研究.
- 了解实施动态对于改善LTC的护理质量至关重要.
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