评估在初级保健机构实施研究的综合框架的使用情况:系统性审查
Andréa Tenório Correia da Silva1, Liza Yurie Teruya Uchimura2, Kelvin Hiromiti Albuquerque Yokota3
1Universidade de São Paulo and Faculdade de Ciências Médicas da Santa Casa de São Paulo, Av. Dr. Arnaldo, 455-Cerqueira César, São Paulo-SP, 01246-903, Brazil. andreatenorio@usp.br.
Implementation science communications
|February 24, 2026
概括
本系统性审查探讨了初级保健中的实施研究综合框架 (CFIR),发现其应用正在增加,但需要改进. 建议包括加强社区参与和报告,以构建更好地与初级保健原则保持一致的理由.
科学领域:
- 实施科学 实施科学
- 医疗保健服务研究 医疗服务研究
- 初级保健研究研究初级保健研究
背景情况:
- 之前对实施研究综合框架 (CFIR) 的系统性审查集中在二级/三级护理上,忽视了初级护理.
- 初级保健的独特原则 (第一接触,连续性,全面性,协调性,以人为中心) 可能会限制从其他环境中直接翻译CFIR发现.
- 在初级保健背景下CFIR的应用和调整仍未得到充分研究.
研究的目的:
- 系统地审查CFIR在初级保健机构中的应用.
- 评估CFIR构造与初级保健的指导原则的一致性.
- 提出改进建议,以加强CFIR在初级保健中的未来应用.
主要方法:
- 从2009年到2024年2月,Scopus和PubMed搜索了使用"CFIR"和"初级保健"的研究.
- 包括对初级保健中的临床,组织或服务交付干预措施的研究.
- 提取了关于研究设计,参与者,健康主题,CFIR领域/结构,理由和与世卫组织初级保健原则一致的数据.
主要成果:
- 105项研究符合纳入标准,自2015年以来,CFIR在初级保健中的使用量增加.
- 大多数研究都是定性性的,重点关注非传染性疾病,实施后,医疗保健工作人员的看法,并在高收入国家进行.
- 虽然61%的人使用了所有五个CFIR领域,但超过一半的人没有报告理由;一些结构与以人为中心和全面性相一致.
结论:
- 在初级保健中CFIR的改进包括在整个研究过程中加强社区参与.
- 报告CFIR构造选择的理由及其与初级保健原则的结合至关重要.
- 建议加强实施前评估和加强卫生政策中的实施研究.
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