Department of Nursing, Université Laval, Québec, Canada.
Implement Sci. 2010 Nov 2;5:85. doi: 10.1186/1748-5908-5-85.
Colorectal cancer (CRC) represents a serious and growing health problem in Canada. Colonoscopy is used for screening and diagnosis of symptomatic or high CRC risk individuals. Although a number of countries are now implementing quality colonoscopy services, knowledge synthesis of barriers and facilitators perceived by healthcare professionals and patients during implementation has not been carried out. In addition, the perspectives of various stakeholders towards the implementation of quality colonoscopy services and the need of an efficient organisation of such services have been reported in the literature but have not been synthesised yet. The present study aims to produce a comprehensive synthesis of actual knowledge on the barriers and facilitators perceived by all stakeholders to the implementation of quality colonoscopy services in Canada.
First, we will conduct a comprehensive review of the scientific literature and other published documentation on the barriers and facilitators to implementing quality colonoscopy services. Standardised literature searches and data extraction methods will be used. The quality of the studies and their relevance to informing decisions on colonoscopy services implementation will be assessed. For each group of users identified, barriers and facilitators will be categorised and compiled using narrative synthesis and meta-analytical techniques. The principle factors identified for each group of users will then be validated for its applicability to various Canadian contexts using the Delphi study method. Following this study, a set of strategies will be identified to inform decision makers involved in the implementation of quality colonoscopy services across Canadian jurisdictions.
This study will be the first to systematically summarise the barriers and facilitators to implementation of quality colonoscopy services perceived by different groups and to consider the local contexts in order to ensure the applicability of this knowledge to the particular realities of various Canadian jurisdictions. Linkages with strategic partners and decision makers in the realisation of this project will favour the utilisation of its results to support strategies for implementing quality colonoscopy services and CRC screening programs in the Canadian health system.
结直肠癌（CRC）在加拿大是一个严重且日益严重的健康问题。结肠镜检查用于筛查和诊断有症状或 CRC 风险高的个体。尽管许多国家现在正在实施质量结肠镜检查服务，但尚未对医疗保健专业人员和患者在实施过程中感知到的障碍和促进因素进行知识综合。此外，文献中已经报道了不同利益相关者对实施质量结肠镜检查服务的看法以及对这种服务进行有效组织的需求，但尚未进行综合。本研究旨在综合所有利益相关者对在加拿大实施质量结肠镜检查服务的障碍和促进因素的实际知识。
首先，我们将对有关实施质量结肠镜检查服务的障碍和促进因素的科学文献和其他已发表文献进行全面综述。将使用标准化的文献搜索和数据提取方法。将评估研究的质量及其对结肠镜检查服务实施决策的相关性。对于确定的每个用户组，将使用叙述性综合和荟萃分析技术对障碍和促进因素进行分类和汇编。然后，使用德尔菲研究方法，验证针对每个用户组确定的主要因素在各种加拿大背景下的适用性。在这项研究之后，将确定一系列策略，为参与加拿大各司法管辖区质量结肠镜检查服务实施的决策者提供信息。
这项研究将首次系统地总结不同群体对实施质量结肠镜检查服务的障碍和促进因素的看法，并考虑当地情况，以确保该知识适用于各种加拿大司法管辖区的具体现实。与战略合作伙伴和决策者在该项目中的联系将有利于利用其结果来支持在加拿大卫生系统中实施质量结肠镜检查服务和 CRC 筛查计划的策略。
