Donald Maoliosa, Beanlands Heather, Straus Sharon, Harwood Lori, Herrington Gwen, Waldvogel Blair, Delgado Maria, Sparkes Dwight, Watson Paul, Elliott Meghan, McBrien Kerry, Bello Aminu, Hemmelgarn Brenda
Department of Medicine, University of Calgary, HSC G239, 3330 Hospital Drive NW, Calgary, AB T2N 4N1 Canada.
Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON Canada.
Glob Implement Res Appl. 2022;2(1):85-94. doi: 10.1007/s43477-022-00038-3. Epub 2022 Jan 30.
Self-management in chronic kidney disease (CKD) can slow disease progression; however, there are few tools available to support patients with early CKD. is a patient-focused electronic health (eHealth) self-management tool developed by patients and caregivers. This study will investigate the implementation of across primary care and general nephrology clinics. The study aims to: (1) identify and address barriers and facilitators that may impact implementation and sustainability of the website into routine clinical care; (2) evaluate implementation quality to inform spread and scale-up. We will conduct a multi-stage approach using qualitative methods, guided by the Quality Implementation Framework and using a qualitative content analysis approach. First, we will identify perceived barriers and facilitators to implementation and considerations for sustainability through interviews with clinicians, based on the Readiness Thinking Tool and the Long Term Success Tool. Analysis will be guided by the Consolidated Framework for Implementation Research and the Theoretical Domains Framework. Appropriate implementation strategies will be identified using the Expert Recommendations for Implementing Change compilation, and implementation plans will be developed based on Proctor's recommendations and the Action, Actor, Context, Target, Time framework. Finally, we will explore implementation quality guided by the RE-AIM framework. There is limited literature describing systematic approaches to implementing and sustaining patient-focused self-management tools into clinical care, in addition to employing tailored implementation strategies to promote adoption and sustainability. We aim to generate insights on how can be integrated into clinical care and how to sustain use of patient-centric eHealth tools in clinical settings on a larger scale.
The online version contains supplementary material available at 10.1007/s43477-022-00038-3.
慢性肾脏病（CKD）的自我管理可以减缓疾病进展；然而，支持早期CKD患者的工具很少。 是一款由患者和护理人员开发的以患者为中心的电子健康（eHealth）自我管理工具。本研究将调查 在初级保健和普通肾脏病诊所的实施情况。该研究旨在：（1）识别并解决可能影响该网站在常规临床护理中实施和可持续性的障碍及促进因素；（2）评估实施质量，为推广和扩大规模提供信息。我们将采用多阶段方法，运用定性方法，以质量实施框架为指导，并采用定性内容分析方法。首先，我们将通过与临床医生的访谈，基于准备度思维工具和长期成功工具，识别实施过程中感知到的障碍和促进因素以及可持续性的考量因素。分析将以实施研究综合框架和理论领域框架为指导。将使用实施变革专家建议汇编来确定适当的实施策略，并根据普罗克特的建议和行动、行动者、背景、目标、时间框架制定实施计划。最后，我们将在RE-AIM框架的指导下探索实施质量。除了采用量身定制的实施策略来促进采用和可持续性外，描述将以患者为中心的自我管理工具系统地实施并维持到临床护理中的文献有限。我们旨在深入了解如何将 整合到临床护理中，以及如何在更大规模的临床环境中维持以患者为中心的eHealth工具的使用。
在线版本包含可在10.1007/s43477-022-00038-3获取的补充材料。
