Developing a theory-based taxonomy of methods for implementing change in practice
Developing a theory-based taxonomy of methods for implementing change in practice
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DOI：
10.1111/j.1365-2648.2006.04207.x
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发表时间：
2007-04-01
影响因子：
3.8
通讯作者：
Sandelowski, Margarete
中科院分区：
文献类型：
--
作者：
Leeman, Jennifer;Baernholdt, Marianne;Sandelowski, Margarete
目的。在本文中，我们提出了一种基于理论的用于在实践中实施变革的方法的分类。背景。实施研究的特点是所采用的方法的术语不一致，并且不关注不同学科方法的相关性差异。对实施有效性的研究得出了不同的结果。所显示的积极影响很小。在实践中实施变革的许多努力取得的成功有限，部分原因可能是缺乏一个框架来指导实施方法的使用。实施方法的临时分类法源自理论和现有分类法，用于对 43 份实证研究报告的方便样本进行内容分析，这些报告涉及 1995 年至 2005 年间出版的一项或多项涉及护士的基于研究的实践变革的实施。该分类法在整个分析过程中进行了修订，以更完整地捕获每份报告中的信息。调查结果。经过分析，临时分类中的 11 种方法中有 9 种被保留，两种被删除，并确定了 5 种新方法。最终分类包括 14 种实施方法，分为五类： (a) 加强协调； (b) 提高认识； (c) 通过人际渠道进行说服； (d) 通过强化信念来说服，即行为将带来理想的结果，以及 (e) 增加行为控制。结论。这里提出的分类法与以前的分类法不同，它侧重于护理，并为实施方法提供了清晰且相互排斥的指南。通过从理论中推导初始编码策略，分类法将方法与理论构造联系起来，这些理论构造可以为不同实践变化和设置中的方法选择提供信息。
Aim. In this paper we present a theory-based taxonomy of the methods used to implement change in practice.Background. Implementation research is characterized by inconsistent terminology for the methods employed and inattention to differences in the relevance of methods across different disciplines. Studies of the effectiveness of implementation have yielded mixed results. Positive effects shown have been small. The limited success of many efforts to implement change in practice may be due, in part, to the absence of a framework to guide the use of implementation methods.Method. A provisional taxonomy of implementation methods, derived from theory and existing taxonomies, was used to content analyse a convenience sample of 43 reports of empirical studies of the implementation of one or more research-based practice changes involving nurses that had been published between 1995 and 2005. This taxonomy was revised throughout the course of analysis to capture more completely the information in each report.Findings. Following the analysis, nine of the 11 methods in the provisional taxonomy were retained, two were removed and five new methods were identified. The final taxonomy includes 14 implementation methods organized into five categories: (a) increasing coordination; (b) raising awareness; (c) persuasion via interpersonal channels; (d) persuasion via reinforcing belief that behaviour will lead to desirable results and (e) increasing behavioural control.Conclusions. The taxonomy presented here differs from prior taxonomies by focusing on nursing and by providing a clear and mutually exclusive guide to implementation methods. By deriving the initial coding strategy from theory, the taxonomy links the methods to theoretical constructs that may inform the selection of methods across different practice changes and settings.