护理学报 ›› 2023, Vol. 30 ›› Issue (11): 47-52.doi: 10.16460/j.issn1008-9969.2023.11.047
实施性研究综合框架（CFIR）更新版的解析和应用
张兰萍1, 吕森森1, 何文俊1, 陈江芸1, 蔡毅媛2, 李春萍1, 刘思源1, 钟冬梅1, 李嘉琪1, 谢昀筠1, 黄婉晴1, 陈晓珊1, 徐东1,3,4
- 1.南方医科大学卫生管理学院卫生管理系Acacia实施科学实验室,广东 广州 510515;
2.贵州医科大学公共卫生与健康学院,贵州 贵阳 550000;
3.南方医科大学世界卫生组织研究中心,广东 广州 510515;
4.南方医科大学皮肤病医院全球健康研究中心,广东 广州 510515
摘要： 目的 实施性研究综合框架（Consolidated Framework for Implementation Research, CFIR）是迄今为止得到最广泛应用的实施科学框架之一。本文旨在全面介绍更新版的实施性研究综合框架,以期为研究者运用该更新版提供借鉴。方法 通过检索与实施性研究综合框架相关的文献,描述CFIR更新版的开发、构成要素以及具体应用。结果 CFIR开发团队在CFIR 2009内容映射的基础上,根据用户反馈对CFIR 2009进行框架、维度和构念3个层次的更新和优化,最终形成了5个维度和48个构念的更新版CFIR。结论 CFIR更新版为使用者提供了一个有力的工具,以更全面、准确地分析和评估实施干预的因素,然而仍存在一定的局限性,使用者应结合研究具体需求进行适当的应用。
中图分类号:
- R472
| [1] Thyer B A.What is evidence-based practice?[J].Brief Treat. Crisis Inter, 2004,4(2):167-176. DOI: 10.1093/brief-treatment/mhh013. [2] Eccles M,Mittman B.Welcome to implementation science[J]. Implement Sci, 2006,1:1. DOI: 10.1186/1748-5908-1-1. [3] Nilsen P.Making sense of implementation theories, models, and frameworks[J]. Implement Sci, 2015,10:53. DOI: 10.1186/s13012-015-0242-0. [4] Damschroder LJ, Aron DC, Keith RE, et al.Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science[J]. Implement Sci, 2009,4(1):1-15. DOI: 10.1186/1748-5908-4-50. [5] Kirk MA, Kelley C, Yankey N, et al.A systematic review of the use of the Consolidated Framework for Implementation Research[J]. Implement Sci, 2015,11(1):1-13. DOI:10.1186/s13012-016-0437-z. [6] Damschroder LJ, Reardon CM, Widerquist MAO, et al.The updated Consolidated Framework for Implementation Research based on user feedback[J]. Implement Sci, 2022,17(1):1-16. DOI: 10.1186/s13012-022-01245-0. [7] Greenhalgh T, Robert G, Macfarlane F, et al.Diffusion of innovations in service organizations: systematic review and recommendations[J]. Milbank Q, 2004,82(4):581-629. DOI: 10.1111/j.0887-378X.2004.00325.x. [8] Breimaier HE, Heckemann B, Halfens RJ, et al.The Consolidated Framework for Implementation Research (CFIR): a useful theoretical framework for guiding and evaluating a guideline implementation process in a hospital-based nursing practice[J]. BMC Nurs, 2015,14:1-9. DOI: 10.1186/s12912-015-0088-4. [9] Means AR, Kemp CG, Gwayi-Chore MC, et al.Evaluating and optimizing the consolidated framework for implementation research (CFIR) for use in low- and middle-income countries: a systematic review[J]. Implement Sci, 2020,15(1):1-19. DOI: 10.1186/s13012-020-0977-0. [10] Birken SA, Powell BJ, Presseau J, et al.Combined use of the Consolidated Framework for Implementation Research (CFIR) and the Theoretical Domains Framework (TDF): a systematic review[J]. Implement Sci, 2017,12(1):1-14. DOI: 10.1186/s13012-016-0534-z. [11] King DK, Shoup JA, Raebel MA, et al.Planning for implementation success using RE-AIM and CFIR frameworks: a qualitative study[J]. Front Public Health, 2020,8:59. DOI: 10.3389/fpubh.2020.00059. [12] Schroeder D, Luig T, Finch TL, et al.Understanding implementation context and social processes through integrating Normalization Process Theory (NPT) and the Consolidated Framework for Implementation Research (CFIR)[J]. Implement Sci Commun, 2022,3(1):1-16. DOI: 10.1186/s43058-022-00264-8. [13] Chan PS, Fang Y, Wong MC, et al.Using Consolidated Framework for Implementation Research to investigate facilitators and barriers of implementing alcohol screening and brief intervention among primary care health professionals: a systematic review[J]. Implement Sci, 2021,16(1):1-40. DOI: 10.1186/s13012-021-01170-8. [14] Godbee K, Gunn J, Lautenschlager NT, et al.Refined conceptual model for implementing dementia risk reduction: incorporating perspectives from Australian general practice[J]. Aust J Prim Health, 2020,26(3):247-255. DOI: 10.1071/PY19249. [15] van Oers HA, Teela L, Schepers SA, et al. A retrospective assessment of the KLIK PROM portal implementation using the Consolidated Framework for Implementation Research (CFIR)[J]. Qual Life Res, 2021,30(11):3049-3061. DOI: 10.1007/s11136-020-02586-3. [16] Sorensen JL, Kosten T.Developing the tools of implementation science in substance use disorders treatment: applications of the consolidated framework for implementation research[J]. Psychol Addict Behav, 2011,25(2):262-8. DOI: 10.1037/a0022765. [17] Tinc PJ, Wolf-Gould C, Wolf-Gould C, et al.Longitudinal use of the Consolidated Framework for Implementation Research to evaluate the creation of a rural center of excellence in transgender health[J]. Int J Environ Res Public Health, 2020,17(23):9047. DOI: 10.3390/ijerph17239047. [18] Ware P, Ross HJ, Cafazzo JA, et al.Evaluating the implementation of a mobile phone-based telemonitoring program: longitudinal study guided by the consolidated framework for implementation research[J]. JMIR Mhealth Uhealth, 2018,6(7):e10768. DOI: 10.2196/10768. [19] Safaeinili N, Brown-Johnson C, Shaw JG, et al.CFIR simplified: Pragmatic application of and adaptations to the Consolidated Framework for Implementation Research (CFIR) for evaluation of a patient-centered care transformation within a learning health system[J]. Learn Health Syst, 2019,4(1):e10201. DOI: 10.1002/lrh2.10201. [20] Miake-Lye IM, Delevan DM, Ganz DA, et al.Unpacking organizational readiness for change: an updated systematic review and content analysis of assessments[J].BMC Health Serv Res,2020,20(1):1-13.DOI:10.1186/s12913-020-4926-z. [21] Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions[J]. Implement Sci, 2011,6(1):1-12. DOI: 10.1186/1748-5908-6-42. [22] 张秋雯,庞冬,胡嘉乐,等.实施性研究综合框架(CFIR)的构成要素解读[J]. 中国循证医学杂志, 2021, 21(3):355-360. DOI:10.7507/1672-2531.202008076. [23] 张秋雯,庞冬,胡嘉乐,等.实施性研究综合框架的发展及其应用[J].中国护理管理, 2021, 21(2): 257-260. DOI: 10.3969/j.issn.1672-1756.2021.02.020. [24] 张婷婷,南奕,姜垣.戒烟服务现状概述[J].中国健康教育, 2015, 31(8):779-781;794. DOI:10.16168/j.cnki.issn.1002-9982.2015.08.017. [25] Stead LF, Bergson G, Lancaster T. Physician advice for smoking cessation[J]. Cochrane Database Syst Rev, 2008,(2):CD000165. DOI: 10.1002/14651858.CD000165.pub4. [26] West R, Raw M, McNeill A, et al. Health-care interventions to promote and assist tobacco cessation: a review of efficacy, effectiveness and affordability for use in national guideline development[J]. Addiction, 2015,110(9):1388-403. DOI: 10.1111/add.12998. [27] Waltz TJ, Powell BJ, Fernández ME, et al.Choosing implementation strategies to address contextual barriers: diversity in recommendations and future directions[J]. Implement Sci, 2019,14(1):1-15. DOI: 10.1186/s13012-019-0892-4. [28] Proctor EK, Landsverk J, Aarons G, et al.Implementation research in mental health services: an emerging science with conceptual, methodological, and training challenges[J]. Adm Policy Ment Health, 2009,36(1):24-34. DOI: 10.1007/s10488-008-0197-4. [29] Reilly KL, Kennedy S, Porter G, et al.Comparing, Contrasting, and Integrating Dissemination and Implementation Outcomes Included in the RE-AIM and Implementation Outcomes Frameworks[J]. Front Public Health, 2020, 8:430. DOI: 10.3389/fpubh.2020.00430. [30] May CR, Cummings A, Girling M, et al.Using Normalization Process Theory in feasibility studies and process evaluations of complex healthcare interventions: a systematic review[J]. Implement Sci, 2018,13(1):1-27. DOI: 10.1186/s13012-018-0758-1. [31] Lett E, Adekunle D, McMurray P, et al. Health equity tourism: ravaging the justice landscape[J]. J Med Syst, 2022,46(3):17. DOI: 10.1007/s10916-022-01803-5. [32] Damschroder LJ, Reardon, CM, Opra Widerquist MA, et al. Conceptualizing outcomes for use with the Consolidated Framework for Implementation Research (CFIR): the CFIR Outcomes Addendum[J]. Implement Sci, 2022,17(1):1-10. DOI: 10.1186/s13012-021-01181-5. |
| [1] | 魏大琼, 龙春花, 吴丝丝, 胡雁. 急性心肌梗死患者早期运动康复的循证护理实践[J]. 护理学报, 2023, 30(11): 53-58. |
| [2] | 姚晶晶, 刘颖, 许汇娟, 孙思敏, 陈敏, 江雪杰. 急性白血病患者化疗相关便秘预防和管理的循证护理实践[J]. 护理学报, 2022, 29(8): 40-45. |
| [3] | 付艳芬, 王春青, 胡雁. 证据临床转化中障碍因素和促进因素的内容分析[J]. 护理学报, 2022, 29(5): 64-68. |
| [4] | 林俏, 刘梅娟, 张广清, 赵芯梅, 夏燕飞, 施燕, 曾依婷, 赖女珍, 周丽华, 李秀梅. 成人炎症性肠病患者饮食与营养方案的循证实践[J]. 护理学报, 2022, 29(4): 27-33. |
| [5] | 周毅峰, 杨继平, 彭瑶丽, 袁浩, 石泽亚. 体外循环心脏手术中体温管理循证实践[J]. 护理学报, 2022, 29(3): 40-45. |
| [6] | 侯香传, 伍艳婷, 周凯琪, 莫怡坚, 黄丽香, 刘伊莎. 提高呼吸系统疾病患者痰标本采集合格率的循证实践[J]. 护理学报, 2022, 29(24): 43-48. |
| [7] | 张俊峰, 陈妙婷, 黄雪玲, 李美连, 蔡莹莹, 吴艳妮, 全守波, 刘兴玲. 胃肠肿瘤根治术后患者自控镇痛管理的循证实践[J]. 护理学报, 2022, 29(23): 50-55. |
| [8] | 黎紫艳, 温秀兰, 黄海英, 张立力, 张智英, 张晓红, 何梦雪, 沈南平, 吴玮哲. 肿瘤患儿化疗相关性恶心呕吐症状管理的循证实践[J]. 护理学报, 2022, 29(14): 43-47. |
| [9] | 翁瑛丽, 王素芬, 陈雪梅. 解释脑卒中后吞咽障碍循证护理转化效果的现实主义综述[J]. 护理学报, 2022, 29(12): 39-44. |
| [10] | 邓瑛瑛, 裴华清, 任英, 殷春梅, 文梅, 张小玲. 预防神经外科重症患者PICC相关性静脉血栓的循证护理实践[J]. 护理学报, 2022, 29(11): 36-40. |
| [11] | 吴晓珩, 杨元立, 胡馨予, 王翠萍, 张萦, 王艳春, 陶艳玲. 住院患者输血全流程管理的循证实践[J]. 护理学报, 2021, 28(8): 33-38. |
| [12] | 周毅峰, 杨继平, 袁浩, 吴娟. 体外循环心脏手术中体温管理证据汇总[J]. 护理学报, 2021, 28(5): 26-31. |
| [13] | 王晓艳, 李牧玲, 谢亭平, 庄卓洵, 何水秀, 郑晓霞, 祝静雯, 陆云涛, 周宏珍. 神经外科患者腰椎穿刺术后最佳卧床时间的循证实践[J]. 护理学报, 2021, 28(4): 31-35. |
| [14] | 郭汉画, 陈名桂, 孔丽丽, 张晓璇. 重症患者动脉测压导管最佳更换策略的循证实践[J]. 护理学报, 2021, 28(2): 37-41. |
| [15] | 王瑞娜, 赖晓帆, 黄斌英, 李焱, 张瑞. 预防住院患者经鼻管喂养非计划拔管的循证护理实践[J]. 护理学报, 2021, 28(19): 44-47. |
|