Alghamdi Alaa, Abrams Ruth, Bailey Julia V, Alves Paula, Park Sophie
Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, London, UK
Family Physician and researcher, King Fahad University Hospital, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
BMJ Open. 2022 Apr 26;12(4):e055959. doi: 10.1136/bmjopen-2021-055959.
Saudi Arabia (SA) has a rapidly developing universal healthcare system which is maturing from its hospital focused origins. However, health service usage suggests that up to 65% of the cases seen in emergency departments were classified as non-urgent and could have been appropriately managed in primary healthcare (PHC) settings. Primary care development in SA has lagged behind secondary care, and evidence suggests that Saudi citizens are currently ambivalent or dissatisfied with their PHC services. Previous research has focused on the quality and patient satisfaction of PHC services in SA. Yet, uncertainty still exists about causal explanations for patient engagement with PHC services and what refinements are needed for PHC. Less attention has been paid to how patient engagement strategies might work differently, which is increasingly recognised as important in PHC services. The aim of this review is to understand the causal explanations for patient engagement with PHC and to generate theory of how the intended outcome of patient engagement with PHC in SA might be achieved through identified contexts and mechanisms.
A realist review approach will be used to synthesise the evidence. Databases including Medline, EMBASE and CINAHL will be searched. Literature will be included if it has relevance to the research question, and is trustworthy in nature. All document types will be screened including peer reviewed articles, relevant grey literature and related media items. All study types will be included. Stakeholders' feedback will also inform our review. A realist approach is suitable for this review because patient engagement with PHC services is a complex phenomenon. A range of different relevant data will be included in the following stages: developing an initial programme theory, searching the evidence, selecting data, extracting data, synthesising data and refining the programme theory.
This study will use secondary data, and stakeholders are involved only to shape our understanding of the important contexts in patient engagement; hence, a formal ethics review is not required. Findings will be disseminated in a peer-reviewed journal and at relevant conferences.
CRD42020175955.
沙特阿拉伯（SA）拥有一个快速发展的全民医疗保健系统，该系统正从以医院为重点的起源逐渐成熟。然而，卫生服务使用情况表明，急诊科所诊治病例中高达65%被归类为非紧急情况，本可在初级医疗保健（PHC）机构得到适当处理。沙特阿拉伯的初级医疗保健发展落后于二级医疗保健，有证据表明沙特公民目前对其初级医疗保健服务矛盾心理或不满意。先前的研究集中在沙特阿拉伯初级医疗保健服务的质量和患者满意度上。然而，对于患者参与初级医疗保健服务的因果解释以及初级医疗保健需要哪些改进，仍然存在不确定性。对于患者参与策略可能如何不同地发挥作用的关注较少，而这在初级医疗保健服务中日益被认为很重要。本综述的目的是了解患者参与初级医疗保健的因果解释，并生成关于如何通过确定的背景和机制实现沙特阿拉伯患者参与初级医疗保健预期结果的理论。
将采用现实主义综述方法来综合证据。将检索包括Medline、EMBASE和CINAHL在内的数据库。如果文献与研究问题相关且本质上可信，则将其纳入。将筛选所有文档类型，包括同行评审文章、相关灰色文献和相关媒体报道。将纳入所有研究类型。利益相关者的反馈也将为我们的综述提供信息。现实主义方法适用于本综述，因为患者参与初级医疗保健服务是一个复杂的现象。在以下阶段将纳入一系列不同的相关数据：制定初始项目理论、检索证据、选择数据、提取数据、综合数据以及完善项目理论。
本研究将使用二手数据，利益相关者仅参与塑造我们对患者参与重要背景的理解；因此，无需进行正式的伦理审查。研究结果将在同行评审期刊和相关会议上传播。
PROSPERO注册号：CRD42020175955。
