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范围综述,旨在确定改善初级保健中医护协作和整合的策略和干预措施。

Scoping review to identify strategies and interventions improving interprofessional collaboration and integration in primary care.

机构信息

Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium

Centre of Research and Innovations in Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.

出版信息

BMJ Open. 2022 Oct 27;12(10):e062111. doi: 10.1136/bmjopen-2022-062111.

Abstract

OBJECTIVE

To identify strategies and interventions used to improve interprofessional collaboration and integration (IPCI) in primary care.

DESIGN

Scoping review DATA SOURCES: Specific Medical Subject Headings terms were used, and a search strategy was developed for PubMed and afterwards adapted to Medline, Eric and Web of Science.

STUDY SELECTION

In the first stage of the selection, two researchers screened the article abstracts to select eligible papers. When decisions conflicted, three other researchers joined the decision-making process. The same strategy was used with full-text screening. Articles were included if they: (1) were in English, (2) described an intervention to improve IPCI in primary care involving at least two different healthcare disciplines, (3) originated from a high-income country, (4) were peer-reviewed and (5) were published between 2001 and 2020.

DATA EXTRACTION AND SYNTHESIS

From each paper, eligible data were extracted, and the selected papers were analysed inductively. Studying the main focus of the papers, researchers searched for common patterns in answering the research question and exposing research gaps. The identified themes were discussed and adjusted until a consensus was reached among all authors.

RESULTS

The literature search yielded a total of 1816 papers. After removing duplicates, screening titles and abstracts, and performing full-text readings, 34 papers were incorporated in this scoping review. The identified strategies and interventions were inductively categorised under five main themes: (1) Acceptance and team readiness towards collaboration, (2) acting as a team and not as an individual; (3) communication strategies and shared decision making, (4) coordination in primary care and (5) integration of caregivers and their skills and competences.

CONCLUSIONS

We identified a mix of strategies and interventions that can function as 'building blocks', for the development of a generic intervention to improve collaboration in different types of primary care settings and organisations.

摘要

目的

确定改善初级保健中多专业协作和整合(IPCI)的策略和干预措施。

设计

范围审查。

数据来源

使用特定的医学主题词,并为 PubMed 开发了一种搜索策略,然后将其改编为 Medline、Eric 和 Web of Science。

研究选择

在选择的第一阶段,两名研究人员筛选了文章摘要,以选择合格的论文。当决策发生冲突时,另外三名研究人员加入了决策过程。使用相同的策略进行全文筛选。如果文章符合以下条件,则将其纳入:(1)为英文;(2)描述了一项改善初级保健中 IPCI 的干预措施,至少涉及两个不同的医疗保健学科;(3)源自高收入国家;(4)经过同行评审;(5)发表于 2001 年至 2020 年之间。

数据提取和综合

从每篇论文中提取合格数据,并对选定的论文进行归纳分析。研究人员通过研究论文的主要关注点,寻找回答研究问题和暴露研究差距的共同模式。确定的主题进行了讨论和调整,直到所有作者达成共识。

结果

文献检索共产生 1816 篇论文。在去除重复项、筛选标题和摘要以及进行全文阅读后,共有 34 篇论文纳入本范围审查。确定的策略和干预措施被归纳为五个主要主题:(1)对协作的接受和团队准备;(2)作为一个团队而不是个人行事;(3)沟通策略和共同决策;(4)初级保健中的协调;(5)护理人员及其技能和能力的整合。

结论

我们确定了一系列策略和干预措施,可以作为“构建块”,用于开发一种通用干预措施,以改善不同类型的初级保健环境和组织中的协作。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f5a/9621161/6495ac9261aa/bmjopen-2022-062111f01.jpg

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