Li Wenhui, Su Min, Li Zhengrong, Fan Xiaojing
School of Public Administration, Inner Mongolia University, Hohhot, China.
School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China.
Health Res Policy Syst. 2025 Jan 27;23(1):15. doi: 10.1186/s12961-024-01277-6.
Challenges in the patient-provider relationship are prevalent, underscoring the importance of patient-centred care, which is respectful and responsive to patients' needs. General practitioners (GPs), also known as family doctors, serve as gatekeepers in primary care and are well positioned to deliver this type of care. However, effectively implementing patient-centred care remains a challenge. While behaviour change interventions have been developed to enhance patient-centred care in general practices, a comprehensive understanding of the facilitators and barriers to their implementation is lacking. This review aims to examine contextual factors of implementing interventions for patient-centred care by GPs. Implementation research analyses all aspects of application, including factors influencing it, processes involved and outcomes achieved within different contexts. The review will use the updated Consolidated Framework for Implementation Research (CFIR 2.0) to analyse influential factors and the Behaviour Change Wheel (BCW) to define interventions to promote behaviour change in patient-centred care.
This systematic literature review will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search of five databases (Ovid MEDLINE, CINAHL, EMBASE, Cochrane Library and Web of Science) will be conducted to identify barriers and facilitators for implementing interventions in promoting patient-centred care by GPs. The CFIR 2.0 framework will guide the categorization and synthesis of barriers and facilitators, while the BCW will be employed to define the interventions. Two independent reviewers will conduct study screening, data extraction, quality appraisal and data analysis. Any disagreements between the reviewers will be resolved through the involvement of additional reviewers.
This protocol outlines a systematic review utilizing an updated framework-based approach to identify and synthesize evidence on barriers and facilitators to implementing behaviour change interventions by GPs. The findings will provide insights into the effectiveness of these interventions in enhancing patient-centred care and will inform future research and clinical practice. This review will identify gaps and challenges in existing studies and propose strategies for the effective implementation of behavior change interventions among GPs. Additionally, it will inform clinical practice by refining behaviour change interventions to enhance the delivery of patient-centred care by GPs.
PROSPERO: CRD42023485014.
医患关系中的挑战普遍存在，这凸显了以患者为中心的医疗服务的重要性，即以尊重和回应患者需求为核心。全科医生（GPs），也被称为家庭医生，是初级医疗服务的守门人，非常适合提供这种类型的医疗服务。然而，有效实施以患者为中心的医疗服务仍然是一项挑战。虽然已经开发了行为改变干预措施来加强全科医疗中的以患者为中心的医疗服务，但对于这些措施实施的促进因素和障碍仍缺乏全面的了解。本综述旨在研究全科医生实施以患者为中心的医疗服务干预措施的背景因素。实施研究分析应用的各个方面，包括影响因素、涉及的过程以及在不同背景下取得的成果。本综述将使用更新后的实施研究综合框架（CFIR 2.0）来分析影响因素，并使用行为改变轮（BCW）来定义促进以患者为中心的医疗服务中行为改变的干预措施。
本系统文献综述将遵循系统评价和Meta分析的首选报告项目（PRISMA）指南。将对五个数据库（Ovid MEDLINE、CINAHL、EMBASE、Cochrane图书馆和科学网）进行全面检索，以确定全科医生实施促进以患者为中心的医疗服务干预措施的障碍和促进因素。CFIR 2.0框架将指导障碍和促进因素的分类和综合，而BCW将用于定义干预措施。两名独立的评审员将进行研究筛选、数据提取、质量评估和数据分析。评审员之间的任何分歧将通过额外评审员的参与来解决。
本方案概述了一项系统综述，采用基于更新框架的方法来识别和综合关于全科医生实施行为改变干预措施的障碍和促进因素的证据。研究结果将深入了解这些干预措施在加强以患者为中心的医疗服务方面的有效性，并为未来的研究和临床实践提供参考。本综述将识别现有研究中的差距和挑战，并提出在全科医生中有效实施行为改变干预措施的策略。此外，它将通过完善行为改变干预措施为临床实践提供参考，以加强全科医生提供以患者为中心的医疗服务。
PROSPERO：CRD42023485014。
