Barriers and enablers to the implementation and sustainability of short-stay arthroplasty programs for elective primary total hip and knee replacement: A systematic review with qualitative evidence synthesis.

IF 1.5 Q3 RHEUMATOLOGY Musculoskeletal Care Pub Date : 2024-06-01 DOI:10.1002/msc.1897
Danielle Berkovic, Patrick Vallance, Ian A Harris, Justine M Naylor, Peter L Lewis, Richard de Steiger, Rachelle Buchbinder, Zanfina Ademi, Ilana N Ackerman
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Abstract

Introduction: We aimed to systematically review contemporary evidence on the barriers and enablers to implementing and sustaining short-stay arthroplasty programs for elective primary total hip and knee replacement from the perspectives of patients, health professionals, carers, healthcare administrators, funders and policymakers and to map the findings to the Theoretical Domains Framework (TDF).

Methods: Medline, Cumulative Index to Nursing and Allied Health Literature, EMBASE, and the Cochrane Central Register of Controlled Trials were searched (up to 19 August 2023). Primary qualitative or mixed-methods studies reporting on perspectives relating to the review aims that utilised a short-stay programme were eligible for inclusion. Study quality was assessed using the qualitative critical appraisal tool from the Joanna Briggs Institute. Data were analysed inductively. The final themes were mapped to the TDF. The confidence in the findings was assessed using GRADE CERQual.

Results: Fifteen studies were included. Twelve barrier themes and twelve enabler themes were identified. Three themes were graded with high confidence, 10 were graded with moderate confidence, three were graded with low confidence, and eight were graded with very low confidence. The most pertinent domains that the themes were mapped to for patients were beliefs about capabilities, reinforcement, and the environmental context and resources. Health professionals identified knowledge, environmental context and resources as important domains. Two domains were identified for carers: (1) social/professional role and identity and (2) memory, attention, and decision processes.

Conclusion: We identified key barrier and enabler themes linked to the TDF that can be used to guide implementation initiatives and promote the sustainability of short-stay arthroplasty programs.

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实施短期关节置换计划并使其可持续发展的障碍和有利因素:系统回顾与定性证据综述。
导言:我们旨在从患者、医疗专业人员、护理人员、医疗管理者、资助者和政策制定者的角度出发,系统地回顾有关实施和维持短期关节置换计划的障碍和促进因素的当代证据,并将研究结果与理论领域框架(TDF)进行对比:方法:检索 Medline、《护理与专职医疗文献累积索引》、EMBASE 和《Cochrane 对照试验中央登记册》(截至 2023 年 8 月 19 日)。与综述目的相关的、采用短期项目的主要定性或混合方法研究均符合纳入条件。研究质量采用乔安娜-布里格斯研究所(Joanna Briggs Institute)提供的定性关键评估工具进行评估。对数据进行归纳分析。最终的主题被映射到 TDF 中。使用 GRADE CERQual 对研究结果的可信度进行评估:结果:共纳入 15 项研究。确定了 12 个障碍主题和 12 个促进主题。其中 3 个主题被评为高度可信,10 个主题被评为中度可信,3 个主题被评为低度可信,8 个主题被评为极低度可信。这些主题与患者最相关的领域是能力信念、强化、环境背景和资源。医疗专业人员认为知识、环境背景和资源是重要的领域。照顾者的两个领域是:(1) 社会/专业角色和身份;(2) 记忆、注意力和决策过程:我们确定了与 TDF 相关的关键障碍和促进因素主题,可用于指导实施计划和促进短期关节置换术计划的可持续性。
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来源期刊
Musculoskeletal Care
Musculoskeletal Care RHEUMATOLOGY-
CiteScore
2.30
自引率
7.70%
发文量
88
期刊介绍: Musculoskeletal Care is a peer-reviewed journal for all health professionals committed to the clinical delivery of high quality care for people with musculoskeletal conditions and providing knowledge to support decision making by professionals, patients and policy makers. This journal publishes papers on original research, applied research, review articles and clinical guidelines. Regular topics include patient education, psychological and social impact, patient experiences of health care, clinical up dates and the effectiveness of therapy.
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