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康复领域知识的转化:系统综述

Translating knowledge in rehabilitation: systematic review.

作者信息

Jones C Allyson, Roop Sanjesh C, Pohar Sheri L, Albrecht Lauren, Scott Shannon D

机构信息

C.A. Jones, PT, PhD, Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 2-50 Corbett Hall, Edmonton, Alberta, Canada T6G 2G4.

S.C. Roop, BKin, School of Public Health, University of Alberta.

出版信息

Phys Ther. 2015 Apr;95(4):663-77. doi: 10.2522/ptj.20130512. Epub 2014 Jun 5.

Abstract

BACKGROUND

Clinicians are faced with using the current best evidence to make treatment decisions, yet synthesis of knowledge translation (KT) strategies that influence professional practice behaviors in rehabilitation disciplines remains largely unknown.

PURPOSE

The purposes of this study were: (1) to examine the state of science for KT strategies used in the rehabilitation professions (physical therapy, occupational therapy, speech-language pathology), (2) to identify the methodological approaches utilized in studies exploring KT strategies, and (3) to report the extent that KT interventions are described.

DATA SOURCES

Eight electronic databases (MEDLINE, CINAHL, ERIC, PASCAL, EMBASE, IPA, Scopus, and CENTRAL) were searched from January 1985 to May 2013 using language (English) restriction.

STUDY SELECTION

Eligibility criteria specified articles evaluating interventions or strategies with a primary purpose of translating research or enhancing research uptake into clinical practice.

DATA EXTRACTION

Two reviewers independently screened the titles and abstracts, reviewed full-text articles, performed data extraction, and performed quality assessment. The published descriptions of the KT interventions were compared with the Workgroup for Intervention Development and Evaluation Research's (WIDER) Recommendations to Improve the Reporting of the Content of Behaviour Change Interventions.

DATA SYNTHESIS

Of a total of 2,793 articles located and titles and abstracts screened, 26 studies were included in the systematic review. Eighteen articles reported interventions that used a multicomponent KT strategy. Education-related components were the predominant KT intervention regardless of whether it was a single or multicomponent intervention. Few studies used reminders or audit and feedback intervention (n=3). Only one study's primary outcome measure was an economic evaluation. No clear delineation of the effect on KT strategies was seen.

LIMITATIONS

Diverse studies were included; however, the heterogeneity of the studies was not conducive to pooling the data.

CONCLUSIONS

The modest-to-low methodological quality assessed in the studies underscores the gaps in KT strategies used in rehabilitation and highlights the need for rigorously designed studies that are well reported.

摘要

背景

临床医生面临着运用当前最佳证据来做出治疗决策的情况,然而,影响康复学科专业实践行为的知识转化(KT)策略的综合情况在很大程度上仍不为人所知。

目的

本研究的目的是:(1)审视康复专业(物理治疗、职业治疗、言语语言病理学)中使用的KT策略的科学现状;(2)确定探索KT策略的研究中所采用的方法学途径;(3)报告KT干预措施的描述程度。

数据来源

从1985年1月至2013年5月,使用语言限制(英语)对八个电子数据库(MEDLINE、CINAHL、ERIC、PASCAL、EMBASE、IPA、Scopus和CENTRAL)进行了检索。

研究选择

纳入标准明确规定文章需评估以将研究转化或增强研究在临床实践中的应用为主要目的的干预措施或策略。

数据提取

两名评审员独立筛选标题和摘要、审阅全文、进行数据提取并进行质量评估。将KT干预措施的已发表描述与干预措施开发与评估研究工作组(WIDER)关于改进行为改变干预措施内容报告的建议进行比较。

数据综合

在总共检索到并筛选了标题和摘要的2793篇文章中,有26项研究被纳入系统评价。18篇文章报告了使用多成分KT策略的干预措施。无论干预措施是单一成分还是多成分,与教育相关的成分都是主要的KT干预措施。很少有研究使用提醒或审核与反馈干预措施(n = 3)。只有一项研究的主要结局指标是经济评估。未发现对KT策略效果的明确界定。

局限性

纳入了多样化的研究;然而,研究的异质性不利于数据汇总。

结论

研究中评估的方法学质量从中等到低,这凸显了康复中使用的KT策略存在的差距,并强调了需要设计严谨且报告完善的研究。

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