从理论到实践:使用规范化过程理论和理论领域框架来理解脱碳在一般实践中的实施。

IF 2.4 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Ana Raquel Nunes, Helen Atherton, Frederik Dahlmann, Abi Eccles, Olivia Geddes, Michael Gregg, Florence Karaba, Rachel Spencer, Helen Twohig, Jeremy Dale
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引用次数: 0

摘要

背景:脱碳在一般实践中是实现净零医疗保健系统的关键一步。了解促进或阻碍实施环境可持续做法的因素对于采取有效和公平的行动至关重要。因此,本研究的总体目标是促进对一般实践中影响脱碳的因素的理解。本研究的目的是绘制和比较标准化过程理论(NPT)和理论领域框架(TDF)在理解一般实践中与脱碳相关的关键因素和子因素方面的应用。方法:由10名编码器组成的多学科团队,包括学术全科医生(gp)、研究人员和患者代表,将系统回顾和叙事综合得出的因素映射到NPT结构和TDF结构域。映射是独立进行的,编码器协议在分类中的一致性和可靠性进行了评估。结果:该研究确定了关键的NPT(“一致性”、“集体行动”和“认知参与”)和TDF领域(“环境背景和资源”、“知识”和“社会/专业角色和身份”)与先前研究中确定的因素相关,这些因素与在一般实践中实现脱碳有关。高互码器可靠性(NPT为73%,TDF为84%)支持了分析的一致性,特别是对于财务激励和政策支持等结构化驱动因素。结论:研究结果表明,NPT和TDF框架对一般实践中影响脱碳的因素提供了有用的见解,尽管不完整。在制定以证据为基础的促进脱碳战略时,这些因素需要更多的关注,这是未来研究可以评估的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
From theory to practice: using the Normalization Process Theory and Theoretical Domains Framework to understand implementation of decarbonization in general practice.

Background: Decarbonization in general practice is a critical step toward achieving a net zero healthcare system. Understanding the factors that facilitate or hinder the implementation of environmentally sustainable practices is essential for effective and equitable action. Hence, the overarching aim of this study is to advance understanding of the factors influencing decarbonization in general practice. This study's objective is to map and compare the application of the Normalization Process Theory (NPT) and Theoretical Domains Framework (TDF) in understanding the key factors and sub-factors related to decarbonization in general practice.

Methods: Factors derived from a systematic review and narrative synthesis were mapped to NPT constructs and TDF domains by a multidisciplinary team of 10 coders, including academic general practitioners (GPs), researchers, and patient representatives. The mapping was conducted independently, and coder agreement was evaluated for consistency and reliability in categorization.

Results: The study identifies key NPT ('Coherence', 'Collective Action', and 'Cognitive Participation') and TDF domains ('Environmental Context and Resources', 'Knowledge', and 'Social/professional role and identity') associated with factors identified in previous research as being associated with achieving decarbonization in general practice. A high intercoder reliability rate (73% for NPT, 84% for TDF) supports the consistency of the analysis, particularly for structured drivers such as financial incentives and policy support.

Conclusions: The findings demonstrate that the NPT and TDF frameworks provide useful, though incomplete, insights into factors influencing decarbonization in general practice. Such factors require more attention when developing evidence-based strategies for promoting decarbonization, something that future research could evaluate.

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来源期刊
Family practice
Family practice 医学-医学:内科
CiteScore
4.30
自引率
9.10%
发文量
144
审稿时长
4-8 weeks
期刊介绍: Family Practice is an international journal aimed at practitioners, teachers, and researchers in the fields of family medicine, general practice, and primary care in both developed and developing countries. Family Practice offers its readership an international view of the problems and preoccupations in the field, while providing a medium of instruction and exploration. The journal''s range and content covers such areas as health care delivery, epidemiology, public health, and clinical case studies. The journal aims to be interdisciplinary and contributions from other disciplines of medicine and social science are always welcomed.
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