School of Healthcare, University of Leicester, College of Life Sciences, Leicester, Leicestershire, UK.
School of Healthcare, University of Leicester, College of Life Sciences, Leicester, Leicestershire, UK
BMJ Open. 2023 Feb 17;13(2):e065121. doi: 10.1136/bmjopen-2022-065121.
Oropharyngeal dysphagia (OD) affects around 15% of older people; however, it is often unrecognised and underdiagnosed until patients are hospitalised. Screening is an important process which aims to facilitate proactive assessment, diagnosis and management of health conditions. Healthcare systems do not routinely screen for OD in older people, and healthcare professionals (HCPs) are largely unaware of the need to screen. This realist review aims to identify relevant literature and develop programme theories to understand what works, for whom, under what circumstances and how, to facilitate primary care HCPs to recognise, screen and initially diagnose OD.
We will follow five steps for undertaking a realist review: (1) clarify the scope, (2) literature search, (3) appraise and extract data, (4) evidence synthesis and (5) evaluation. Initial programme theories (IPTs) will be constructed after the preliminary literature search, informed by the Theoretical Domains Framework and with input from a stakeholder group. We will search Medline, Google Scholar, PubMed, EMBASE, CINAHL, AMED, Scopus and PsycINFO databases. We will obtain additional evidence through grey literature, snowball sampling, lateral searching and consulting the stakeholder group. Literature will be screened, evaluated and synthesised in Covidence. Evidence will be assessed for quality by evaluating its relevance and rigour. Data will be extracted and synthesised according to their relation to IPTs. We will follow the Realist and Meta-narrative Evidence Syntheses: Evolving Standards quality and publication standards to report study results.
Formal ethical approval is not required for this review. We will disseminate this research through publication in a peer-reviewed journal, written pieces targeted to diverse groups of HCPs on selected online platforms and public engagement events.
CRD42022320327.
口咽吞咽困难（OD）影响约 15%的老年人；然而，直到患者住院，它才经常被忽视和漏诊。筛查是一个重要的过程，旨在促进对健康状况的主动评估、诊断和管理。医疗保健系统通常不会对老年人进行 OD 筛查，医疗保健专业人员（HCP）也大多没有意识到需要进行筛查。本真实主义审查旨在确定相关文献，并制定方案理论，以了解什么有效、对谁有效、在什么情况下有效以及如何有效，以促进初级保健 HCP 识别、筛查和初步诊断 OD。
我们将遵循进行真实主义审查的五个步骤：（1）阐明范围，（2）文献检索，（3）评估和提取数据，（4）证据综合，（5）评估。初始方案理论（IPT）将在初步文献检索后构建，由理论领域框架提供信息，并由利益相关者小组提供意见。我们将在 Medline、Google Scholar、PubMed、EMBASE、CINAHL、AMED、Scopus 和 PsycINFO 数据库中进行搜索。我们将通过灰色文献、滚雪球抽样、横向搜索和咨询利益相关者小组获取额外的证据。文献将在 Covidence 中进行筛选、评估和综合。将通过评估其相关性和严谨性来评估证据的质量。将根据与 IPT 的关系提取和综合数据。我们将遵循真实主义和元叙述证据综合：不断发展的标准质量和发布标准来报告研究结果。
本审查不需要正式的伦理批准。我们将通过在同行评议的期刊上发表文章、在选定的在线平台上针对不同群体的 HCP 撰写文章以及举办公众参与活动来传播这项研究。
PROSPERO 注册号：CRD42022320327。
