如何以及为何教育干预措施能够提高养老院医护人员对谵妄的认知：一项真实主义综述研究方案。

How and why educational interventions work to increase knowledge of delirium among healthcare professionals in nursing homes: a protocol for a realist review.

机构信息

Faculty of Health, School of Nursing Science, Witten/ Herdecke University, Witten, Germany

Institute of General Practice and Family Medicine (AM RUB), Faculty of Medicine, Ruhr University Bochum, Bochum, Germany.

出版信息

BMJ Open. 2023 Jul 26;13(7):e072591. doi: 10.1136/bmjopen-2023-072591.

DOI:10.1136/bmjopen-2023-072591

PMID:37495388

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10373687/

Abstract

BACKGROUND

Delirium is a neuropathological condition that impairs cognitive performance, attention and consciousness and can be potentially life-threatening. Nursing home residents are particularly vulnerable to developing delirium, but research thus far tends to focus on the acute hospital setting. Healthcare professionals (HCPs) working in nursing homes seem to be little aware of delirium. To improve healthcare for affected or at-risk individuals, increasing knowledge among HCPs is highly relevant. Using the realist review method helps to understand how and why an educational intervention for HCPs on delirium in nursing homes works.

METHODS AND ANALYSIS

In accordance with the Realist And Meta-narrative Evidence Syntheses: Evolving Standards publication standards for realist syntheses, the review process will include the following five steps: (1) search strategy and literature review; (2) study selection and assessment; (3) data extraction; (4) data synthesis and (5) development of an initial programme theory. The literature search will be conducted in the databases Medline (PubMed), CINAHL (Ebsco), Scopus, Web of Science, GeroLit and Carelit. Additional focuses are on snowballing techniques, hand research and grey literature. Studies of any design will be included to develop the initial programme theory. The literature will be selected by two researchers independently. In addition, the experiences of HCPs from nursing homes will be reflected in group discussions. To this end, Context-Mechanism-Outcome configurations (CMOcs) will be established to develop an initial programme theory.

ETHICS AND DISSEMINATION

The results will be disseminated within the scientific community. For this purpose, presentations at scientific conferences as well as publications in peer-reviewed journals are scheduled. In the next step, the CMOcs could serve for the development of a complex educational intervention to increase the knowledge of HCPs on delirium in nursing homes.

REGISTRATION DETAILS

This protocol has been registered at Open Science Framework (https://doi.org/10.17605/OSF.IO/HTFU4).

摘要

背景

谵妄是一种神经病理学状况，会损害认知表现、注意力和意识，并可能危及生命。养老院居民特别容易出现谵妄，但迄今为止的研究往往侧重于急性医院环境。在养老院工作的医疗保健专业人员（HCP）似乎对谵妄知之甚少。为了改善受影响或有风险的个体的医疗保健，提高 HCP 对谵妄的认识非常重要。使用真实主义审查方法有助于理解针对养老院 HCP 的谵妄教育干预措施的工作方式和原因。

方法和分析

根据真实主义和元叙述证据综合：不断发展的标准对真实主义综合的标准，审查过程将包括以下五个步骤：（1）搜索策略和文献综述；（2）研究选择和评估；（3）数据提取；（4）数据综合；（5）初始方案理论的制定。文献检索将在 Medline（PubMed）、CINAHL（Ebsco）、Scopus、Web of Science、GeroLit 和 Carelit 数据库中进行。另外的重点是滚雪球技术、手工研究和灰色文献。任何设计的研究都将被纳入，以制定初始方案理论。文献将由两名研究人员独立选择。此外，养老院的 HCP 经验将反映在小组讨论中。为此，将建立上下文-机制-结果配置（CMOcs）以制定初始方案理论。