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从行为改变理论领域探讨影响医院辅助医疗专业人员将证据转化为临床实践的因素:一项系统综述

Factors Influencing the Translation of Evidence Into Clinical Practice for Hospital Allied Health Professionals in Terms of the Domains of Behaviour Change Theory: A Systematic Review.

作者信息

Batchelor Jacqueline, Hemmert Cameron, Meulenbroeks Isabelle, Tang Crystal, Harrison Reema, Ogrin Rajna, Baillie Andrew, Sarkies Mitchell

机构信息

University of Sydney, Australia.

Implementation Science Academy, Australia.

出版信息

Eval Health Prof. 2024 Sep 23:1632787241285993. doi: 10.1177/01632787241285993.

Abstract

This systematic review provides an overview of the unique challenges allied health professions face in the translation and implementation of evidence into practice, which remain relatively under reported and uninformed by a theoretical basis of behaviour change. MEDLINE, EMBASE, CINAHL and Scopus databases from 2010 to 2022 were searched for primary study designs resulting in 21 articles included in this review (PROSPERO: 2022 CRD42022314996). Allied health disciplines reported in the review were mainly from occupational therapy, physiotherapy, dietetics, and speech pathology. The most frequently reported implementation determinants across the Theoretical Domains Framework were identified as 'environmental context and resources', and 'knowledge'. The results also identified a greater influence of 'social influences' and 'beliefs about consequences' in implementation. Implementing evidence into clinical practice is a multifaceted, complex process, and the use of the Theoretical Domains Framework provided a systematic approach to understanding the drivers behind the target behaviours. However, there is a paucity of studies across the allied health professions that describe implementation strategies used and their impact. Many of the studies focused on implementation by the individual clinician rather than the role organizations can play in the translation of evidence into practice.

摘要

本系统评价概述了健康照护相关专业在将证据转化并应用于实践过程中所面临的独特挑战,这些挑战的报道相对较少,且缺乏行为改变理论基础的支撑。检索了2010年至2022年期间MEDLINE、EMBASE、CINAHL和Scopus数据库中的原始研究设计,最终纳入本评价的有21篇文章(PROSPERO:2022 CRD42022314996)。评价中报道的健康照护相关学科主要来自职业治疗、物理治疗、饮食学和言语病理学。在理论领域框架中,最常报道的实施决定因素被确定为“环境背景和资源”以及“知识”。结果还确定了“社会影响”和“对后果的信念”在实施过程中的更大影响。将证据应用于临床实践是一个多方面的复杂过程,使用理论领域框架提供了一种系统的方法来理解目标行为背后的驱动因素。然而,健康照护相关专业中描述所使用的实施策略及其影响的研究较少。许多研究关注的是个体临床医生的实施情况,而非组织在将证据转化为实践中所能发挥的作用。

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