Understanding context: A concept analysis.

concept analysis context health care implementation knowledge translation work organization

Journal

Journal of advanced nursing
ISSN: 1365-2648
Titre abrégé: J Adv Nurs
Pays: England
ID NLM: 7609811

Informations de publication

Date de publication:
Dec 2019
Historique:
received: 21 05 2019
revised: 24 06 2019
accepted: 03 07 2019
pubmed: 31 7 2019
medline: 9 6 2020
entrez: 31 7 2019
Statut: ppublish

Résumé

To conduct a concept analysis of clinical practice contexts (work environments) in health care. Context is increasingly recognized as important to the development, delivery, and understanding of implementation strategies; however, conceptual clarity about what comprises context is lacking. Modified Walker and Avant concept analysis comprised of five steps: (1) concept selection; (2) determination of aims; (3) identification of uses of context; (4) determination of its defining attributes; and (5) definition of its empirical referents. A wide range of databases were systematically searched from inception to August 2014. Empirical articles were included if a definition and/or attributes of context were reported. Theoretical articles were included if they reported a model, theory, or framework of context or where context was a component. Double independent screening and data extraction were conducted. Analysis was iterative, involving organizing and reorganizing until a framework of domains, attributes. and features of context emerged. We identified 15,972 references, of which 70 satisfied our inclusion criteria. In total, 201 unique features of context were identified, of these 89 were shared (reported in two or more studies). The 89 shared features were grouped into 21 attributes of context which were further categorized into six domains of context. This study resulted in a framework of domains, attributes and features of context. These attributes and features, if assessed and used to tailor implementation activities, hold promise for improved research implementation in clinical practice. 目标: 对卫生保健的临床实践环境(工作环境)进行概念分析。 背景: 环境对实施战略的制定、实施和理解越来越重要;然而,关于什么组成环境的概念缺乏清晰度。 设计: 改进的Walker和Avant概念分析包括五个步骤:(1)概念选择;(2)目标的确定;(3)识别环境用途;(4)确定定义属性;(5)实证指示物的定义。 方法: 从数据库启用到2014年8月,对大范围的数据库进行系统检索。如果报告了背景的定义和/或属性,那么实证文章就被包括在内。如果理论文章报告了背景的模型、理论或框架或者背景是其中的一个组成部分,那么它们就被包括在内。进行了双独立筛选和数据提取。分析是迭代的,包括组织和重新组织,直到出现一个领域、属性和背景特性的框架。 结果: 我们确定了15972篇参考文献,其中70篇符合我们的纳入标准。总共有201个独特的环境特征被识别出来,其中89个是共享的(在两个或更多的研究中有报道)。89个共享特征被分为21个环境属性,并进一步划分为6个环境领域。 结论: 本研究建立了一个包含环境领域、属性和特征的框架。如果这些属性和特征得到评估并用于定制实施活动,将有望改善临床实践中的研究实施。.

Sections du résumé

AIMS OBJECTIVE
To conduct a concept analysis of clinical practice contexts (work environments) in health care.
BACKGROUND BACKGROUND
Context is increasingly recognized as important to the development, delivery, and understanding of implementation strategies; however, conceptual clarity about what comprises context is lacking.
DESIGN METHODS
Modified Walker and Avant concept analysis comprised of five steps: (1) concept selection; (2) determination of aims; (3) identification of uses of context; (4) determination of its defining attributes; and (5) definition of its empirical referents.
METHODS METHODS
A wide range of databases were systematically searched from inception to August 2014. Empirical articles were included if a definition and/or attributes of context were reported. Theoretical articles were included if they reported a model, theory, or framework of context or where context was a component. Double independent screening and data extraction were conducted. Analysis was iterative, involving organizing and reorganizing until a framework of domains, attributes. and features of context emerged.
RESULT RESULTS
We identified 15,972 references, of which 70 satisfied our inclusion criteria. In total, 201 unique features of context were identified, of these 89 were shared (reported in two or more studies). The 89 shared features were grouped into 21 attributes of context which were further categorized into six domains of context.
CONCLUSION CONCLUSIONS
This study resulted in a framework of domains, attributes and features of context. These attributes and features, if assessed and used to tailor implementation activities, hold promise for improved research implementation in clinical practice.
目标: 对卫生保健的临床实践环境(工作环境)进行概念分析。 背景: 环境对实施战略的制定、实施和理解越来越重要;然而,关于什么组成环境的概念缺乏清晰度。 设计: 改进的Walker和Avant概念分析包括五个步骤:(1)概念选择;(2)目标的确定;(3)识别环境用途;(4)确定定义属性;(5)实证指示物的定义。 方法: 从数据库启用到2014年8月,对大范围的数据库进行系统检索。如果报告了背景的定义和/或属性,那么实证文章就被包括在内。如果理论文章报告了背景的模型、理论或框架或者背景是其中的一个组成部分,那么它们就被包括在内。进行了双独立筛选和数据提取。分析是迭代的,包括组织和重新组织,直到出现一个领域、属性和背景特性的框架。 结果: 我们确定了15972篇参考文献,其中70篇符合我们的纳入标准。总共有201个独特的环境特征被识别出来,其中89个是共享的(在两个或更多的研究中有报道)。89个共享特征被分为21个环境属性,并进一步划分为6个环境领域。 结论: 本研究建立了一个包含环境领域、属性和特征的框架。如果这些属性和特征得到评估并用于定制实施活动,将有望改善临床实践中的研究实施。.

Autres résumés

Type: Publisher (chi)
目标: 对卫生保健的临床实践环境(工作环境)进行概念分析。 背景: 环境对实施战略的制定、实施和理解越来越重要;然而,关于什么组成环境的概念缺乏清晰度。 设计: 改进的Walker和Avant概念分析包括五个步骤:(1)概念选择;(2)目标的确定;(3)识别环境用途;(4)确定定义属性;(5)实证指示物的定义。 方法: 从数据库启用到2014年8月,对大范围的数据库进行系统检索。如果报告了背景的定义和/或属性,那么实证文章就被包括在内。如果理论文章报告了背景的模型、理论或框架或者背景是其中的一个组成部分,那么它们就被包括在内。进行了双独立筛选和数据提取。分析是迭代的,包括组织和重新组织,直到出现一个领域、属性和背景特性的框架。 结果: 我们确定了15972篇参考文献,其中70篇符合我们的纳入标准。总共有201个独特的环境特征被识别出来,其中89个是共享的(在两个或更多的研究中有报道)。89个共享特征被分为21个环境属性,并进一步划分为6个环境领域。 结论: 本研究建立了一个包含环境领域、属性和特征的框架。如果这些属性和特征得到评估并用于定制实施活动,将有望改善临床实践中的研究实施。.

Identifiants

pubmed: 31359451
doi: 10.1111/jan.14165
doi:

Types de publication

Journal Article Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

3448-3470

Subventions

Organisme : Canadian Institutes of Health Research (CIHR) Operating Grant-Priority Announcement: Knowledge Translation
ID : 201309KTE-319843-KTR-CECA-169494

Informations de copyright

© 2019 John Wiley & Sons Ltd.

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Auteurs

Janet E Squires (JE)

School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.

Ian Graham (I)

Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.

Kainat Bashir (K)

Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.

Letitia Nadalin-Penno (L)

School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.

John Lavis (J)

Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada.
McMaster Health Forum, Hamilton, Ontario, Canada.

Jill Francis (J)

School of Health Sciences, City, University of London, London, United Kingdom.

Janet Curran (J)

IWK Health Centre, Halifax, Nova Scotia, Canada.
School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada.

Jeremy M Grimshaw (JM)

Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Medicine, University of Ottawa, Ottawa, Ontario, Canada.

Jamie Brehaut (J)

Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.

Noah Ivers (N)

Women's College Research Institute, Toronto, Ontario, Canada.
Women's College Hospital, Toronto, Ontario, Canada.
Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.

Susan Michie (S)

Psychology Department, University College London, London, United Kingdom.

Michael Hillmer (M)

Information Management, Data, and Analytics, Ontario Ministry of Health and Long-term Care, Toronto, Ontario, Canada.

Thomas Noseworthy (T)

British Columbia Academic Health Science Network, Vancouver, British Columbia, Canada.

Jocelyn Vine (J)

School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada.
Patient Care, IWK Health Centre, Halifax, Nova Scotia, Canada.

Melissa Demery Varin (M)

School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.

Laura D Aloisio (LD)

Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.

Mary Coughlin (M)

Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.

Alison M Hutchinson (AM)

School of Nursing and Midwifery, Faculty of Health, Deakin University, Melbourne, Victoria, Australia.

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