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弥合心理健康服务机构中研究与实践的差距:实施理论与研究进展综述

Bridging the Gap Between Research and Practice in Mental Health Service Settings: An Overview of Developments in Implementation Theory and Research.

作者信息

Stirman Shannon Wiltsey, Gutner Cassidy A, Langdon Kirsten, Graham Jessica R

机构信息

National Center for PTSD, VA Palo Alto Healthcare System, Stanford University.

National Center for PTSD, VA Boston Healthcare System; Boston University.

出版信息

Behav Ther. 2016 Nov;47(6):920-936. doi: 10.1016/j.beth.2015.12.001. Epub 2015 Dec 21.

Abstract

Twenty years after Sobell's (1996) influential call to integrate advances in behavior therapy into clinical settings, significant progress has been made in implementation science. In this narrative review, we provide an overview of implementation research findings and highlight recent findings that can inform efforts to bridge the gap between research and practice in mental health service settings. Key findings are summarized, organized according to levels of influence described in two implementation frameworks: The Exploration, Planning, Implementation, and Sustainment Framework (EPIS; Aarons et al., 2011) and the Consolidated Framework for Implementation Research (CFIR; Damschroder et al., 2009). Important levels of influence to consider when implementing new treatments include the outer context, inner context, characteristics of the individual, and characteristics of the innovation. Research on strategies to prepare clinicians to deliver evidence-based psychosocial treatments (EBPTs) and to address contextual barriers to implementation at each level is described, with discussion of implications for the implementation of EBPTs and next steps for research.

摘要

在索贝尔(1996年)颇具影响力地呼吁将行为疗法的进展整合到临床环境中二十年后,实施科学已取得重大进展。在这篇叙述性综述中,我们概述了实施研究的结果,并突出了近期的研究发现,这些发现可为弥合心理健康服务环境中研究与实践之间的差距提供参考。关键发现将按照两个实施框架中描述的影响层面进行总结和组织:探索、规划、实施与维持框架(EPIS;阿伦斯等人,2011年)和实施研究综合框架(CFIR;丹施罗德等人,2009年)。在实施新疗法时需要考虑的重要影响层面包括外部环境、内部环境、个体特征和创新特征。文中描述了为使临床医生能够提供循证心理社会治疗(EBPTs)并解决各层面实施过程中的背景障碍而采取的策略研究,并讨论了对EBPTs实施的影响以及下一步的研究方向。

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