School of Nursing and Health Sciences, University of Dundee, Dundee, UK.
Närhälsan Research and Development Primary Health Care, Gothenburg, Sweden.
Disabil Rehabil. 2020 Nov;42(22):3265-3274. doi: 10.1080/09638288.2019.1587013. Epub 2019 Apr 12.
Despite growth in rehabilitation research, implementing research findings into rehabilitation practice has been slow. This creates inequities for patients and is an ethical issue. However, methods to investigate and facilitate evidence implementation are being developed. This paper aims to make these methods relevant and accessible for rehabilitation researchers and practitioners. Rehabilitation practice is varied and complex and occurs within multilevel healthcare systems. Using a "road map" analogy, we describe how implementation concepts and theories can inform implementation strategies in rehabilitation. The roadmap involves a staged journey that considers: the nature of evidence; context for implementation; navigation tools for implementation; strategies to facilitate implementation; evaluation of implementation outcomes; and sustainability of implementation. We have developed a model to illustrate the journey, and four case studies exemplify implementation stages in rehabilitation settings. Effective implementation strategies for the complex world of rehabilitation are urgently required. The journey we describe unpacks that complexity to provide a template for effective implementation, to facilitate translation of the growing evidence base in rehabilitation into improved patient outcomes. It emphasizes the importance of understanding context and application of relevant theory, and highlights areas which should be targeted in new implementation research in rehabilitation.Implications for rehabilitationEffective implementation of research evidence into rehabilitation practice has many interconnected steps and a roadmap analogy is helpful in defining them.Understanding context for implementation is critically important and using theory can facilitate development of understanding.Research methods for implementation in rehabilitation should be carefully selected and outcomes should evaluate implementation success as well as clinical change.Sustainability requires regular revisiting of the interconnected steps.
尽管康复研究有所增长，但将研究结果应用于康复实践的速度一直很慢。这给患者带来了不公平，也是一个道德问题。然而，正在开发调查和促进证据实施的方法。本文旨在使这些方法对康复研究人员和从业者具有相关性和可及性。康复实践具有多样性和复杂性，并发生在多层次的医疗保健系统中。我们使用“路线图”类比来描述实施概念和理论如何为康复中的实施策略提供信息。路线图涉及一个阶段性的旅程，考虑了：证据的性质；实施的背景；实施的导航工具；促进实施的策略；实施结果的评估；以及实施的可持续性。我们开发了一个模型来说明这一旅程，四个案例研究说明了康复环境中的实施阶段。迫切需要为复杂的康复世界制定有效的实施策略。我们所描述的旅程解开了这种复杂性，为有效的实施提供了一个模板，以促进将康复领域不断增长的证据基础转化为改善患者的结果。它强调了理解背景和应用相关理论的重要性，并突出了康复中实施新研究应关注的领域。康复的意义将研究证据有效地应用于康复实践有许多相互关联的步骤，路线图类比有助于定义这些步骤。理解实施背景至关重要，应用理论可以促进对其的理解。应仔细选择康复实施的研究方法，并应评估实施结果以及临床变化来评估实施的成功。可持续性需要定期重新审视相互关联的步骤。
