Faculty of Nursing, Level 3, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Avenue, Edmonton, Alberta, T6G 1C9, Canada.
Lawrence S Bloomberg Faculty of Nursing and Faculties of Medicine and Dentistry, University of Toronto, Toronto, Canada.
Syst Rev. 2022 Oct 15;11(1):221. doi: 10.1186/s13643-022-02093-1.
There is limited evidence to evaluate the sustainability of evidence-based interventions (EBIs) for healthcare improvement. Through an integrative review, we aimed to identify approaches to evaluate the sustainability of evidence-based interventions (EBIs) and sustainability outcomes.
Following Whittemore and Knafl's methodological process: (1) problem identification; (2) literature search; (3) data evaluation; (4) data analysis; and (5) presentation, a comprehensive search strategy was applied across five databases. Included studies were not restricted by research design; and had to evaluate the sustainability of an EBI in a healthcare context. We assessed the methodological quality of studies using the Mixed Methods Appraisal Tool.
Of 18,783 articles retrieved, 64 fit the inclusion criteria. Qualitative designs were most commonly used for evaluation (48%), with individual interviews as the predominant data collection method. Timing of data collection varied widely with post-intervention data collection most frequent (89%). Of the 64 studies, 44% used a framework, 26% used a model, 11% used a tool, 5% used an instrument, and 14% used theory as their primary approach to evaluate sustainability. Most studies (77%) did not measure sustainability outcomes, rather these studies focused on sustainability determinants.
It is unclear which approach/approaches are most effective for evaluating sustainability and what measures and outcomes are most commonly used. There is a disconnect between evaluating the factors that may shape sustainability and the outcomes approaches employed to measure sustainability. Our review offers methodological recommendations for sustainability evaluation research and highlights the importance in understanding mechanisms of sustainability to advance the field.
评估医疗保健改善的循证干预措施（EBIs）的可持续性的证据有限。通过综合审查，我们旨在确定评估循证干预措施（EBIs）可持续性和可持续性结果的方法。
根据 Whittemore 和 Knafl 的方法学过程：（1）问题识别；（2）文献搜索；（3）数据评估；（4）数据分析；（5）呈现，我们在五个数据库中应用了全面的搜索策略。纳入的研究不受研究设计的限制；并且必须评估医疗保健环境中 EBI 的可持续性。我们使用混合方法评估工具评估研究的方法学质量。
在检索到的 18783 篇文章中，有 64 篇符合纳入标准。定性设计最常用于评估（48%），个体访谈是主要的数据收集方法。数据收集的时间范围差异很大，干预后数据收集最为频繁（89%）。在 64 项研究中，44%使用了框架，26%使用了模型，11%使用了工具，5%使用了仪器，14%使用了理论作为评估可持续性的主要方法。大多数研究（77%）没有衡量可持续性结果，而是这些研究侧重于可持续性决定因素。
尚不清楚哪种方法/方法最适合评估可持续性，以及最常用的措施和结果是什么。评估可能影响可持续性的因素与用于衡量可持续性的结果方法之间存在脱节。我们的审查为可持续性评估研究提供了方法学建议，并强调了理解可持续性机制以推进该领域的重要性。
