Evans Catrin, Clancy Georgia, Evans Kerry, Booth Andrew, Nazmeen Benash, Timmons Stephen, Sunney Candice, Clowes Mark, Jones Nia Wyn, Spiby Helen
Professor in Evidence Based Healthcare, School of Health Sciences, University of Nottingham, Nottingham, UK.
Research Fellow, School of Health Sciences, University of Nottingham, Nottingham, UK.
J Res Nurs. 2024 Mar;29(2):127-140. doi: 10.1177/17449871241226911. Epub 2024 Mar 8.
The COVID pandemic prompted an increase in the use of digital clinical consultations (telephone or video calls) within midwifery and nursing care. This paper reports on a realist review project related to maternity care that seeks to illuminate for whom such consultations can safely and acceptably be used, how, for what purposes and in what contexts.
This paper addresses the first phase of a realist enquiry - initial programme theory development - focusing particularly on the role of stakeholder involvement (including digital transformation leaders, midwives, obstetricians, service users and community organisations).
Three sub-stages of initial programme theory development are described highlighting the contribution of stakeholder groups to each stage: (i) consultation to focus the review question, (ii) focused searching and (iii) further consultation.
Realist literature searching strategies yielded limited theory-rich evidence on digital consultations. Stakeholders provided essential additional contributions resulting in the development of 13 initial programme theories and a conceptual framework.
More research on the implementation of virtual midwifery/nursing consultations is needed. Nursing/midwifery digital researchers should involve stakeholders to help shape research priorities, deepen contextual understanding and sense-check emerging findings.
新冠疫情促使助产和护理服务中数字临床会诊（电话或视频通话）的使用增加。本文报告了一项与孕产妇护理相关的现实主义综述项目，旨在阐明哪些人可以安全且可接受地使用此类会诊、如何使用、用于何种目的以及在何种背景下使用。
本文阐述了现实主义探究的第一阶段——初始项目理论发展，特别关注利益相关者参与（包括数字转型领导者、助产士、产科医生、服务使用者和社区组织）的作用。
描述了初始项目理论发展的三个子阶段，突出了利益相关者群体对每个阶段的贡献：（i）进行咨询以聚焦综述问题，（ii）进行针对性检索，以及（iii）进一步咨询。
现实主义文献检索策略获得了关于数字会诊的有限的、富含理论的证据。利益相关者提供了重要的额外贡献，从而形成了13个初始项目理论和一个概念框架。
需要对虚拟助产/护理会诊的实施开展更多研究。护理/助产数字研究人员应让利益相关者参与进来，以帮助确定研究重点、加深对背景的理解并对新出现的研究结果进行合理性检验。
