Nordin Annika, Andersson Gäre Boel, Andersson Ann-Christine
Region Jönköping County, Jönköping Academy for improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
School of Health and Welfare, Jönköping University, Jönköping, Sweden.
J Eval Clin Pract. 2017 Dec;23(6):1329-1335. doi: 10.1111/jep.12782. Epub 2017 Jul 27.
RATIONALE, AIM, AND OBJECTIVE: This study aimed to explore programme theories of a national quality register. A programme theory is a bundle of assumptions underpinning how and why an improvement initiative functions. The purpose was to examine and establish programme theories of a national quality register widely used in Sweden: Senior alert. The paper reports on how programme theories among change recipients emerge in relation to the established programme theory of the initiator.
A qualitative approach and a longitudinal research design were used. To develop programme theories among change recipients, individual semistructured interviews were conducted. Three sets of interviews were conducted in the period of 2011 to 2013, totalling 22 interviews. In addition, 4 participant observations were made. To develop the initiator's programme theory, an iterative multistage collaboration process between the researchers and the initiator was used. A directed content analysis was used to analyse data.
The initiator and change recipients described similar programme logics, but differing programme theories. With time, change recipients' programme theories emerged. Their programme theories converged and became more like the programme theory of the initiator.
This study has demonstrated the importance of making both the initiator's and change recipients' programme theories explicit. To learn about conditions for improvement initiatives, comparisons between their programme theories are valuable. Differences in programme theories provide information on how initiators can customize support for their improvement initiatives. Similar programme logics can be underpinned by different programme theories, which can be deceptive. Programme theories emerge over time and need to be understood as dynamic phenomena.
原理、目的和目标：本研究旨在探索一个国家质量登记册的项目理论。项目理论是一系列支撑改进举措如何运作以及为何运作的假设。目的是审视并确立瑞典广泛使用的一个国家质量登记册——“老年警报”的项目理论。本文报告了变革接受者的项目理论如何相对于发起者既定的项目理论而出现。
采用定性方法和纵向研究设计。为了在变革接受者中形成项目理论，进行了个人半结构化访谈。在2011年至2013年期间进行了三轮访谈，共计22次访谈。此外，还进行了4次参与观察。为了形成发起者的项目理论，研究人员与发起者之间采用了迭代多阶段协作过程。使用定向内容分析法分析数据。
发起者和变革接受者描述了相似的项目逻辑，但项目理论不同。随着时间推移，变革接受者的项目理论出现了。他们的项目理论趋于一致，变得更像发起者的项目理论。
本研究证明了明确发起者和变革接受者的项目理论的重要性。为了了解改进举措的条件，比较他们的项目理论是有价值的。项目理论的差异提供了有关发起者如何为其改进举措定制支持的信息。相似的项目逻辑可能有不同的项目理论作为支撑，这可能具有欺骗性。项目理论会随着时间出现，需要被理解为动态现象。
