Stanhope Jessica, Pearce Claire
International Centre for Allied Health Evidence, University of South Australia, Adelaide, SA, Australia.
J Multidiscip Healthc. 2013 Dec 2;6:423-34. doi: 10.2147/JMDH.S50185.
The purpose of this systematic review was to determine the effectiveness and implementation of advanced allied health assistant roles.
A systematic search of seven databases and Google Scholar was conducted to identify studies published in English peer-reviewed journals from 2003 to 2013 and reporting on the effectiveness and implementation of advanced allied health assistant (A/AHA) roles. Reference lists were also screened to identify additional studies, and the authors' personal collections of studies were searched. Studies were allocated to the National Health and Medical Research Council hierarchy of evidence, and appraisal of higher-level studies (III-1 and above) conducted using the Centre for Evidence Based Medicine Systematic Review Critical Appraisal Sheet for included systematic reviews or the PEDro scale for level II and III-1 studies. Data regarding country, A/AHA title, disciplines, competencies, tasks, level of autonomy, clients, training, and issues regarding the implementation of these roles were extracted, as were outcomes used and key findings for studies investigating their effectiveness.
Fifty-three studies were included, and most because they reported background information rather than investigating A/AHA roles, this representing low-level information. A/AHAs work in a range of disciplines, with a variety of client groups, and in a number of different settings. Little was reported regarding the training available for A/AHAs. Four studies investigated the effectiveness of these roles, finding that they were generally well accepted by clients, and provided more therapy time. Issues in integrating these new roles into existing health systems were also reported.
A/AHA roles are being implemented in a range of settings, and appear to be effective in terms of process measures and stakeholder perceptions. Few studies have investigated these roles, indicating a need for research to be conducted in this area to enable policy-makers to consider the value of these positions and how they can best be utilized.
本系统评价的目的是确定高级联合健康助理角色的有效性及实施情况。
对七个数据库和谷歌学术进行系统检索，以识别2003年至2013年发表在英文同行评审期刊上且报告高级联合健康助理（A/AHA）角色有效性及实施情况的研究。还对参考文献列表进行筛选以识别其他研究，并检索作者的个人研究收藏。将研究分配到澳大利亚国家卫生与医学研究委员会的证据等级体系中，对于较高级别的研究（III-1及以上），使用循证医学中心系统评价批判性评价表对纳入的系统评价进行评价，对于II级和III-1级研究则使用PEDro量表进行评价。提取有关国家、A/AHA职称、学科、能力、任务、自主程度、服务对象、培训以及这些角色实施相关问题的数据，以及研究其有效性时所使用的结果和主要发现。
纳入了53项研究，且大多数研究只是报告了背景信息而非对A/AHA角色进行调查，这属于低水平信息。A/AHA在一系列学科、多种服务对象群体以及多个不同环境中工作。关于A/AHA可获得的培训报道较少。四项研究调查了这些角色的有效性，发现它们总体上得到服务对象的认可，并提供了更多治疗时间。还报告了将这些新角色融入现有卫生系统时存在的问题。
A/AHA角色正在一系列环境中实施，并且在过程指标和利益相关者认知方面似乎是有效的。很少有研究对这些角色进行调查，这表明需要在该领域开展研究，以使政策制定者能够考虑这些职位的价值以及如何能最佳地利用它们。
