School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, China.
Department of Infectious Disease, Shengjing Hospital of China Medical University, No.39 Huaxiang Road, Tiexi District, Shenyang, Liaoning Province, China.
J Tissue Viability. 2023 Aug;32(3):355-364. doi: 10.1016/j.jtv.2023.04.009. Epub 2023 Apr 28.
To systematically synthesize research evidence on barriers and facilitators to pressure injury prevention in hospital settings.
A systematic literature review of quantitative, qualitative, and mixed methods research was undertaken using PubMed, MEDLINE, Embase, CINAHL, and Cochrane Library. Studies that reported barriers or/and facilitators to pressure injury prevention in the acute care settings and published in English from 2008 to 2022 were included. Studies were excluded if they were conducted in residential care facilities and nursing homes, or other long-term community care settings. Two authors independently screened articles against the inclusion and exclusion criteria. Quality appraisal was conducted by two authors by using the Mixed Methods Appraisal Tool. Reported results were mapped to the Theoretical Domains Framework to identify the barriers and facilitators to pressure injury prevention.
A total of 78 studies were included. There were 65 quantitative studies, 11 qualitative studies, and two mix-methods studies. The most salient Theoretical Domains Framework domains identified in this review were "Knowledge", "Skills", "Environmental Context and Resources", "Optimism", "Social/Professional Role and Identity", and "Social influences".
The barriers and facilitators to pressure injury prevention in hospital settings identified in this systematic review were diverse, and included issues at both individual and organizational level. Healthcare organizations can address the barriers and facilitators from the influential Theoretical Domains Framework domains. Future research is required to investigate the effectiveness of behaviour change interventions that specifically target these barriers and facilitators to pressure injury prevention.
系统综合医院环境中预防压力性损伤的障碍和促进因素的研究证据。
对 2008 年至 2022 年期间以英文发表的定量、定性和混合方法研究进行了系统的文献回顾，这些研究报告了急性护理环境中预防压力性损伤的障碍和/或促进因素。如果研究是在住宅护理设施和养老院或其他长期社区护理环境中进行的，则将其排除在外。两名作者独立根据纳入和排除标准筛选文章。两名作者使用混合方法评估工具对质量进行评估。报告的结果被映射到理论领域框架，以确定预防压力性损伤的障碍和促进因素。
共纳入 78 项研究。其中 65 项为定量研究，11 项为定性研究，2 项为混合方法研究。本综述中确定的最显著的理论领域框架领域包括“知识”、“技能”、“环境背景和资源”、“乐观”、“社会/专业角色和身份”和“社会影响”。
本系统综述确定的医院环境中预防压力性损伤的障碍和促进因素多种多样，包括个体和组织层面的问题。医疗保健组织可以从有影响力的理论领域框架领域解决这些预防压力性损伤的障碍和促进因素。需要进一步研究针对这些预防压力性损伤的障碍和促进因素的行为改变干预措施的有效性。
