语境实施 (ICON) 框架:医疗保健中的语境领域,属性和特征的元框架
Janet E Squires1,2, Ian D Graham3,4,5, Wilmer J Santos4
1School of Nursing, University of Ottawa, Ottawa, Canada. janet.squires@uottawa.ca.
Health research policy and systems
|August 7, 2023
概括
这项研究开发了"在上下文中实施"框架,以澄清卫生保健专业人员在研究证据的使用中上下文的作用. 该框架提供了对影响基于证据的实践和实施干预措施的上下文因素的全面理解.
科学领域:
- 实施科学 实施科学
- 医疗保健研究 医疗保健研究
- 基于证据的实践.
背景情况:
- 背景因素显著影响医疗保健专业人员对研究证据的采用.
- 现有的上下文概念缺乏清晰度,阻碍了有效的实施干预.
- 在医疗保健环境中存在对环境的结构化理解的需要.
研究的目的:
- 提升对医疗保健中的背景概念的清晰度.
- 制定"在环境中实施框架".
- 确定影响研究证据使用的上下文领域,属性和特征.
主要方法:
- 三项研究的元综合:对70项文献研究的概念分析,对145项医疗保健专业人员采访的二次分析以及对39名利益相关者的定性采访.
- 为了开发框架,对元合成遵循了严格的协议.
- 通过在上下文和实施科学方面的专家反来完善框架.
主要成果:
- 在上下文框架的实施概念化上下文跨越微 (个人),中 (组织) 和宏 (外部) 的水平.
- 确定了六个上下文领域:行为者,组织气候/结构,社会行为,对变化的反应,过程和外部影响.
- 框架包括22个核心属性和108个特征,说明了上下文元素.
结论:
- 背景实施框架是一个独特的元框架,用于指导医疗保健实施工作.
- 为研究证据在临床实践中使用的背景提供了全面的理解.
- 为干预设计提供信息,有助于干预效应的解释,并增强证据的吸收和可持续性.
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