Noordman Janneke, Meurs Maaike, Poortvliet Rune, Rusman Tamara, Orrego-Villagran Carola, Ballester Marta, Ninov Lyudmil, de Guzmán Ena Niño, Alonso-Coello Pablo, Groene Oliver, Suñol Rosa, Heijmans Monique, Wagner Cordula
Netherlands institute for health services research (Nivel), Utrecht, The Netherlands.
Universitat Autònoma de Barcelona, Barcelona, Spain.
Chronic Illn. 2024 Mar;20(1):3-22. doi: 10.1177/17423953231153337. Epub 2023 Feb 6.
To identify and describe the most relevant contextual factors (CFs) from the literature that influence the successful implementation of self-management interventions (SMIs) for patients living with type 2 diabetes mellitus, obesity, COPD and/or heart failure.
We conducted a qualitative review of reviews. Four databases were searched, 929 reviews were identified, 460 screened and 61 reviews met the inclusion criteria. CFs in this paper are categorized according to the Tailored Implementation for Chronic Diseases framework.
A great variety of CFs was identified on several levels, across all four chronic diseases. Most CFs were on the level of the patient, the professional and the interaction level, while less CFs were obtained on the level of the intervention, organization, setting and national level. No differences in main themes of CFs across all four diseases were found.
For the successful implementation of SMIs, it is crucial to take CFs on several levels into account simultaneously. Person-centered care, by tailoring SMIs to patients' needs and circumstances, may increase the successful uptake, application and implementation of SMIs in real-life practice. The next step will be to identify the most important CFs according to various stakeholders through a group consensus process.
从文献中识别并描述影响2型糖尿病、肥胖症、慢性阻塞性肺疾病（COPD）和/或心力衰竭患者自我管理干预措施（SMIs）成功实施的最相关背景因素（CFs）。
我们进行了一项综述的定性分析。检索了四个数据库，共识别出929篇综述，筛选了460篇，61篇综述符合纳入标准。本文中的背景因素根据慢性病定制实施框架进行分类。
在所有四种慢性病中，在几个层面上都识别出了各种各样的背景因素。大多数背景因素存在于患者层面、专业人员层面和互动层面，而在干预措施层面、组织层面、环境层面和国家层面识别出的背景因素较少。未发现所有四种疾病的背景因素主要主题存在差异。
为了成功实施自我管理干预措施，同时考虑几个层面的背景因素至关重要。通过根据患者需求和情况定制自我管理干预措施，以患者为中心的护理可能会增加自我管理干预措施在实际临床实践中的成功采用、应用和实施。下一步将通过小组共识过程，根据不同利益相关者确定最重要的背景因素。
