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医疗保健领域知识转化的意外负面后果:一项系统性综述。

The unintended negative consequences of knowledge translation in healthcare: A systematic scoping review.

作者信息

Dadich Ann, Vaughan Priya, Boydell Katherine

机构信息

School of Business, Western Sydney University, Parramatta, Australia.

Black Dog Institute, University of New South Wales, Randwick, Australia.

出版信息

Health Sociol Rev. 2023 Mar;32(1):75-93. doi: 10.1080/14461242.2022.2151372. Epub 2023 Jan 20.

Abstract

Knowledge translation represents an avenue to address the oft-cited chasm between what should and what does happen in healthcare. Knowledge translation encompasses myriad processes through which different knowledges coalesce to inform practice. However, some reports suggest that experiences with knowledge translation are less than favourable. To better understand these experiences, a systematic scoping review of academic literature was conducted to unveil the unintended negative consequences of knowledge translation and how they were addressed. After screening 9,598 publications, six reported evidence of unintended negative consequences. The most prevalent was emotional labour - negative emotional or psychological sequelae, depression, anxiety, powerlessness, and frustration. These consequences were experienced by knowledge translation brokers, knowledge translation recipients, and knowledge translation producers. All but one publication offered some discussion of strategies to manage or mitigate these unintended negative consequences, including co-design, collaboration, and supported dialogue. These findings suggest there is limited research that explicates the unintended negative consequences of knowledge translation. Given the importance of knowledge translation, this review indicates there is considerable opportunity to advance it, in a better-informed way. Only by considering the unintended negative consequences of knowledge translation can they be identified, addressed, and potentially moderated, if not averted.

摘要

知识转化是一条弥合医疗保健领域中经常被提及的“应该发生的情况”与“实际发生的情况”之间差距的途径。知识转化涵盖了众多不同知识融合以指导实践的过程。然而,一些报告表明知识转化的实际效果并不理想。为了更好地理解这些情况,我们对学术文献进行了系统的范围综述,以揭示知识转化的意外负面后果以及应对措施。在筛选了9598篇出版物后,有6篇报告了意外负面后果的证据。最普遍的是情感劳动——负面情绪或心理后遗症、抑郁、焦虑、无力感和挫败感。知识转化中介、知识转化接受者和知识转化生产者都经历了这些后果。除了一篇出版物外,其他所有出版物都对管理或减轻这些意外负面后果的策略进行了一些讨论,包括共同设计、协作和支持性对话。这些发现表明,阐释知识转化意外负面后果的研究有限。鉴于知识转化的重要性,本综述表明有相当大的机会以更明智的方式推进它。只有考虑到知识转化的意外负面后果,才能识别、应对并有可能缓和(如果不能避免的话)这些后果。

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