Department of Health Sciences, University of Leicester, George Davies Centre, University Road, Leicester, LE1 7RH, UK.
School of Applied Social Sciences, De Montfort University, Hawthorn Building, The Gateway, Leicester, LE1 9BH, UK.
BMC Fam Pract. 2020 Mar 16;21(1):52. doi: 10.1186/s12875-020-01107-y.
Normalisation Process Theory (NPT) provides a framework to understand how interventions are implemented, embedded, and integrated in healthcare settings. Previous reviews of published literature have examined the application of NPT across international healthcare and reports its benefits. However, given the distinctive clinical function, organisational arrangements and the increasing management of people with a wide variety of conditions in primary care settings in the United Kingdom, it is important to understand how and why authors utilise and reflect on NPT in such settings to inform and evaluate implementation processes.
A systematic review of peer-reviewed literature using NPT in primary care settings in the United Kingdom (UK) was conducted. Eight electronic databases were searched using replicable methods to identify articles published between January 2012 and April 2018. Data were analysed using a framework approach.
Thirty-one articles met the inclusion criteria. Researchers utilised NPT to explore the implementation of interventions, targeting a wide range of health services and conditions, within primary care settings in the UK. NPT was mostly applied qualitatively; however, a small number of researchers have moved towards mixed and quantitative methods. Some variation was observed in the use of NPT constructs and sub-constructs, and whether and how researchers undertook modification to make them more relevant to the implementation process and multiple stakeholder perspectives.
NPT provides a flexible framework for the development and evaluation of complex healthcare interventions in UK primary care settings. This review updates the literature on NPT use and indicates that its application is well suited to these environments, particularly in supporting patients with long-term conditions and co-morbidities. We recommend future research explores the receipt of interventions by multiple stakeholders and suggest that authors reflect on justifications for using NPT in their reporting.
常规化进程理论（NPT）为理解干预措施如何在医疗保健环境中实施、嵌入和整合提供了一个框架。先前对已发表文献的审查检查了 NPT 在国际医疗保健中的应用，并报告了其益处。然而，鉴于英国初级保健环境中独特的临床功能、组织安排和越来越多的对各种条件人群的管理，了解作者如何以及为何在这些环境中利用和反思 NPT 以告知和评估实施过程非常重要。
对英国初级保健环境中使用 NPT 的同行评议文献进行了系统审查。使用可复制的方法对八个电子数据库进行了搜索，以确定 2012 年 1 月至 2018 年 4 月期间发表的文章。使用框架方法分析数据。
31 篇文章符合纳入标准。研究人员利用 NPT 探索了干预措施在英国初级保健环境中的实施情况，这些干预措施针对广泛的卫生服务和条件。NPT 主要是定性应用的；然而，一些研究人员已经转向混合和定量方法。在 NPT 结构和子结构的使用以及研究人员是否以及如何进行修改以使它们更符合实施过程和多个利益相关者的观点方面，观察到一些差异。
NPT 为英国初级保健环境中复杂医疗保健干预措施的开发和评估提供了一个灵活的框架。本综述更新了关于 NPT 使用的文献，并表明其应用非常适合这些环境，特别是在支持患有长期疾病和合并症的患者方面。我们建议未来的研究探索多个利益相关者对干预措施的接受情况，并建议作者在报告中反思使用 NPT 的理由。
