健康服务领域研究成果应用的行动促进框架应用性研究的文献范畴分析

Development and Application of PARIHS:A Scoping Review

目的探讨健康服务领域研究成果应用的行动促进框架(the promoting action on researchimplementation in health services framework,PARIHS)的应用现况,以期为后续的发展提供理论依据。方法 2016年3月,检索PubMed、Embase(Excerpt Medica Database)、EBSCO、JBI循证护理数据库、中国知网、万方、维普等数据库;中文检索词为"健康服务领域研究成果应用的行动促进框架"、"循证实践理论框架/模式"、"证据应用"、"组织变革";英文检索词为"PARIHS"/"parihs"、"evidence-basedpractice"、"implementation"、"evidenceutilization"。检索时限为建库以来至2015年12月31日。采用文献范畴分析的方法,重点分析PARIHS的应用性文献,即运用PARIHS指导循证实践活动。双人进行文献筛选和数据提取。结果共有33篇应用性文献纳入分析。根据PARIHS在不同研究中的作用分为两部分,即以PARIHS为理论框架的应用研究和以PARIHS指导研究设计的应用.研究。前者主要包括对循证实践中的影响因素的探讨、研究应用效果和循证实践实施的准备度/可行性的评估;后者包括基于PARIHS量表/问卷的构建及应用、以PARIHS指导实践策略的制定和以PARIHS为指导的结局资料的分析。结论 PARIHS全面阐释影响循证实践过程的多个元素,并分析了各元素相互作用、相互依存的关系。它可以直接地用于不同的实践项目、不同的环境及证据应用不同的阶段,对医疗机构循证实践的开展有较好的指导作用。

Objective To discuss the application of the promoting action on research implementation in health services frame- work （PARIHS）,in order to provide theoretical evidence of the further development.Methods Databases included PubMed, Excerpt Medica Datahase（Emhase）,EBSCO,JBI,China National Knowledge Infrastructure （CNKI）,Wanfang and VIP were searcbed.Tbe Chinese key words were ＂the promoting action on research implementation in health services framework＂, ＂PARIHS＂/＂parihs＇,＂evidence-based practice＂ and ＂implementation＂, and the English key words were ＂PARIHS＂/＂parihs＂, ＂evidence-hased praetice＂,＂implementation＂ and ＂evidence utilization＂.The time length was between the start of the database to December 31st 2015.By using scoping review method, the literatures about PARIHS were extracted and reviewed by two experts.Results There were 33 articles met the inclusion criteria,based on the role of PARIHS in different resesrcbes,the research effect can divided in two aspects that includes guiding the research design and taki＇ng as theoretical references.The former one included the discussion of the influencing factor ,application effect and the assessment of the preparation degree and feasibility,while the later one included the construction and application of the PARIHS , and the outcome of PARIHS. Gandusion PARIHS can he directly used in different practice projects,different contexts and different stages of evidence- based practice,and it is suitable for the implementation of evidence-based practice inhealth care.