Davies Freya, Wood Fiona, Bullock Alison, Wallace Carolyn, Edwards Adrian
Division of Population Medicine, Cardiff University, Cardiff, UK.
Cardiff Unit for Research and Evaluation in Medical and Dental Education, Cardiff University, Cardiff, UK.
BMJ Open. 2017 Mar 20;7(3):e014575. doi: 10.1136/bmjopen-2016-014575.
Supporting self-management among people with long-term conditions is recognised as an important component of healthcare. Progressive neurological conditions (PNCs), for example, Parkinson's disease and multiple sclerosis are associated with problems such as fatigue and cognitive impairment which may make self-management more challenging. Health professionals may need to develop specific skills in order to provide effective self-management support for these patients. The review aims to develop explanatory theories about how health professional-targeted interventions to improve self-management support provision for people with PNCs operate in different circumstances.
A realist synthesis of the evidence is proposed. There are 2 priority questions for the review to address. These relate to the role of a shared concept of self-management support within the healthcare team, and the need to tailor the support provided to the requirements of people with PNCs. Key stakeholders will be involved throughout the process. The initial search strategy uses terms relating to (1) self-management, (2) health professionals and (3) PNCs. Searching, data extraction and synthesis will occur in parallel. Studies will be prioritised for inclusion based on anticipated contribution to generating explanatory theories. Key informant interviews are planned to direct supplementary searches and help further refine the theories developed. Results will be expressed in the form of context-mechanism-outcome configurations.
Publication guidelines on realist synthesis will be followed. The results will be published in a peer-reviewed journal and made available to organisations involved in the provision of health professional training.
支持慢性病患者的自我管理被视为医疗保健的一个重要组成部分。例如，帕金森病和多发性硬化症等进行性神经系统疾病（PNCs）与疲劳和认知障碍等问题相关，这可能使自我管理更具挑战性。卫生专业人员可能需要培养特定技能，以便为这些患者提供有效的自我管理支持。本综述旨在建立解释性理论，说明针对卫生专业人员的干预措施如何在不同情况下为患有PNCs的人提供更好的自我管理支持。
建议对证据进行实证综合分析。本综述有两个优先问题需要解决。这些问题涉及医疗团队中自我管理支持共享概念的作用，以及根据PNCs患者的需求调整所提供支持的必要性。关键利益相关者将参与整个过程。初始检索策略使用与（1）自我管理、（2）卫生专业人员和（3）PNCs相关的术语。检索、数据提取和综合将并行进行。将根据对生成解释性理论的预期贡献对研究进行优先纳入。计划进行关键信息访谈，以指导补充检索并帮助进一步完善所形成的理论。结果将以背景-机制-结果配置的形式呈现。
将遵循实证综合分析的发表指南。研究结果将发表在同行评审期刊上，并提供给参与卫生专业人员培训的组织。
