Influence of societal and practice contexts on health professionals' clinical reasoning: a scoping study protocol
Influence of societal and practice contexts on health professionals' clinical reasoning: a scoping study protocol
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DOI：
10.1136/bmjopen-2013-002887
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发表时间：
2013-01-01
期刊：
影响因子：
2.9
通讯作者：
Lacasse, Francis
中科院分区：
文献类型：
--
作者：
Carrier, Annie;Levasseur, Melanie;Lacasse, Francis
简介 在资源有限的情况下，干预措施的有效性是全球医疗保健系统的关键目标。如果临床推理（CR）（从业者用来计划、指导、执行和反思客户护理的过程）不是最佳的，那么医疗保健干预措施的效果就会大打折扣。卫生专业人员的 CR 过程受到其社会和实践环境的制度层面（即法律、监管、行政和组织方面）的影响。尽管已经就影响卫生专业人员 CR 的制度层面进行了几项研究，但尚未明确整合其结果。本研究的目的是综合和传播有关制度维度对卫生专业人员 CR 影响的现有知识。方法和分析将对 1980 年 1 月至 2013 年 3 月的科学文献进行范围界定研究，以总结和传播有关制度维度对 CR 影响的研究结果。将检索来自三个相关领域（医疗保健、卫生法以及政治和管理）的大量数据库（n=18）。扩展搜索策略将包括手动搜索参考书目、健康相关网站、公共登记处和感兴趣的期刊。将使用专题图表和内容分析来收集和分析数据。系统的多学科团队方法将允许最佳地识别相关研究，以及有效和有效的内容分析和结果传播。讨论这项范围界定研究将对以下方面的现有知识进行严格、准确和最新的综合：(1) 卫生专业人员的社会和实践环境的制度维度影响其 CR 的那些方面，以及 (2) 这些方面如何影响卫生专业人员的 CR。通过具有广泛专业知识的多学科研究团队的协同作用，将确保临床针对性以及向知识用户详尽传播结果。
Introduction In a context of constrained resources, the efficacy of interventions is a pivotal aim of healthcare systems worldwide. Efficacy of healthcare interventions is highly compromised if clinical reasoning (CR), the process that practitioners use to plan, direct, perform and reflect on client care, is not optimal. The CR process of health professionals is influenced by the institutional dimension (ie, legal, regulatory, administrative and organisational aspects) of their societal and practice contexts. Although several studies have been conducted with respect to the institutional dimension influencing health professionals' CR, no clear integration of their results is yet available. The aim of this study is to synthesise and disseminate current knowledge on the influence of the institutional dimension of contexts on health professionals' CR.Methods and analysis A scoping study of the scientific literature from January 1980 to March 2013 will be undertaken to summarise and disseminate research findings about the influence of the institutional dimension on CR. Numerous databases (n=18) from three relevant fields (healthcare, health law and politics and management) will be searched. Extended search strategies will include the manual search of bibliographies, health-related websites, public registries and journals of interest. Data will be collected and analysed using a thematic chart and content analysis. A systematic multidisciplinary team approach will allow optimal identification of relevant studies, as well as effective and valid content analysis and dissemination of the results.Discussion This scoping study will provide a rigorous, accurate and up-to-date synthesis of existing knowledge regarding: (1) those aspects of the institutional dimension of health professionals' societal and practice contexts that impact their CR and (2) how these aspects influence health professionals' CR. Through the synergy of a multidisciplinary research team from a wide range of expertise, clinical pertinence and an exhaustive dissemination of results to knowledge-users will be ensured.