Alana Delaforce, Emma Maddock, Pamela Wheeler, Rajiv Jayasena, Joy Parkinson
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引用次数: 0
摘要
导言虚拟医疗解决方案在基层医疗机构的使用率呈指数级增长,目前的证据表明,患者的满意度很高,但临床医生的看法却不尽相同。此外,本文还评估了如何利用更新后的实施研究综合框架(CFIR)来评估这些有助于虚拟医疗创新应用的因素:本系统性范围界定综述确定了有关影响澳大利亚初级医疗机构采用虚拟医疗解决方案的因素的实证研究。搜索范围包括 Embase、PubMed、Scopus 和 Web of Science。使用 CFIR 对影响虚拟医疗解决方案实施的因素进行编码。在无法确定合适的 CFIR 结构时,则使用归纳编码法生成新的结构:结果:14 项研究符合纳入条件。确定了五个共同的影响因素。其中三个来自现有的 CFIR 框架,两个是新开发的结构。CFIR 结构包括创新相对优势、能力和 IT 基础设施。新的结构包括可达性和适宜性。此外,还确定了另外六个新结构(信任、隐私、治理、意外后果、偏好和选择),但这些结构并未被重点提及:结论:影响澳大利亚基层医疗机构采用虚拟医疗的共同因素。CFIR有助于将这些因素概念化,但不足以捕捉虚拟医疗的独特因素。新开发的概念在文献中具有重要意义,但还需要进一步研究,以了解这些概念是否适用于多种情况。西班牙文摘要:http://links.lww.com/IJEBH/A286。
Factors that influence the uptake of virtual care solutions in Australian primary care practice: a systematic scoping review.
Introduction: Uptake of virtual care solutions in primary care settings has increased exponentially, and current evidence suggests high patient satisfaction but mixed clinician views.
Aims: This paper aimed to identify factors influencing its' implementation to support delivery to the right patient, in the right clinical context, at the right time. Further, this paper evaluates how the updated Consolidated Framework for Implementation Research (CFIR) can be used to assess these factors that contribute to the uptake of virtual care innovations.
Methods: This systematic scoping review identified empirical research on factors influencing the uptake of virtual care solutions in the Australian primary care setting. Searches were undertaken in Embase, PubMed, Scopus, and Web of Science. The CFIR was used to code factors influencing the implementation of virtual care solutions. Inductive coding was used to generate new constructs where no appropriate CFIR construct could be identified.
Results: Fourteen eligible studies were identified as eligible for inclusion. Five common influencing factors were identified. Three are from the existing CFIR framework, and two are newly developed constructs. CFIR constructs included innovation relative advantage, capability, and IT infrastructure. New constructs included accessibility and suitability. A further six new constructs were identified (trust, privacy, governance, unintended consequences, preference, and choice) but these were not prominently mentioned.
Conclusions: Common factors influence virtual care uptake in Australian primary care. The CFIR assisted in conceptualizing these but was not sufficient for capturing factors unique to virtual care. Newly developed constructs are noted to be of importance in the literature, but further research is needed to understand whether they are applicable in multiple contexts.