Understanding the impact of delegated home visiting services accessed via general practice by community-dwelling patients: a realist review protocol.
Understanding the impact of delegated home visiting services accessed via general practice by community-dwelling patients: a realist review protocol.
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DOI：
10.1136/bmjopen-2018-024876
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发表时间：
2018-11-13
期刊：
影响因子：
2.9
通讯作者：
Park S
中科院分区：
文献类型：
--
作者：
Abrams R;Wong G;Mahtani KR;Tierney S;Boylan AM;Roberts N;Park S
在西方国家，早期就诊服务（EVS）已被提议作为一项最近的干预措施，以减少全科医生的工作量和社区内有医疗保健需求的居家个人的入院率。 EVS 涉及将患者家访委托给其他工作人员团体，例如护理人员或护理人员。然而，组织这种护理的原则尚不清楚，也不清楚不同的环境（例如患者状况和组织 EVS 的过程）如何影响护理结果。旨在了解 EVS 的制定方式，特别是谁受益、为何受益、如何受益以及何时受益，以便进一步深入了解 EVS 的设计和交付。本次审查的目的是得出结论，解释 EVS 环境如何以及为何影响其相关结果。 EVS 的证据将通过现实主义审查（一种理论驱动的证据合成方法）进行巩固。由于 EVS 是一项复杂的干预措施，因此需要采取现实主义的方法。 EVS 所取得的成果可能会因不同的个人和环境而有所不同。我们期望在以下阶段综合一系列相关数据，例如定性、定量和混合方法研究：设计初始程序理论、搜索证据、选择适当的文档、提取数据、综合和完善程序理论。由于本研究是二次研究，因此不需要正式的伦理审查。研究结果将在同行评审期刊、国内和国际会议以及相关专业协会上传播。 CRD42018096518。
In western countries, early visiting services (EVS) have been proposed as a recent intervention to reduce both general practitioner workload and hospital admissions among housebound individuals experiencing a healthcare need within the community. EVS involves the delegation of the patient home visits to other staff groups such as paramedics or nursing staff. However, the principles of organising this care are unknown and it remains unclear how different contexts, such as patient conditions and the processes of organising EVS influence care outcomes. A review has been designed to understand how EVS are enacted and, specifically, who benefits, why, how and when in order to provide further insight into the design and delivery of EVS. The purpose of this review is to produce findings that provide explanations of how and why EVS contexts influence their associated outcomes. Evidence on EVS will be consolidated through realist review—a theory-driven approach to evidence synthesis. A realist approach is needed as EVS is a complex intervention. What EVS achieve is likely to vary for different individuals and contexts. We expect to synthesise a range of relevant data such as qualitative, quantitative and mixed-method research in the following stages: devising an initial programme theory, searching evidence, selecting appropriate documents, extracting data, synthesising and refining the programme theory. A formal ethics review is not required as this study is secondary research. Findings will be disseminated in a peer-reviewed journal, at national and international conferences and to relevant professional associations. CRD42018096518.
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