以质量求发展，以服务铸品牌

护理学报 ›› 2024, Vol. 31 ›› Issue (5): 39-43.doi: 10.16460/j.issn1008-9969.2024.05.039

• 循证护理 • 上一篇    下一篇

实施理论—常态化过程理论的解读

李春萍1a,1b, 张兰萍1b, 王晓辉2, 钟乐欣1b, 杨薇3, 赵青1a,1b, 吕森森1b, 李嘉琪1b, 谢昀筠1b, 黄婉晴1b, 陈晓珊1b, 徐东1b,1c,4,1a   

  1. 1.南方医科大学 a.公共卫生学院;b.卫生管理学院卫生管理系Acacia实施科学实验室;c.世界卫生组织研究中心,广东 广州 510515;
    2.兰州大学 公共卫生学院,甘肃 兰州 730000;
    3.贵州医科大学 公共卫生与健康学院环境污染与疾病监控教育部重点实验室,贵州 贵阳 561113;
    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
  • 收稿日期:2023-12-15 出版日期:2024-03-10 发布日期:2024-04-08
  • 通讯作者: 徐东（1972-）,男,四川乐山人,博士,博士研究生导师,教授,南方医科大学全球健康研究中心执行副主任、世界卫生组织研究中心主任。E-mail: romanxu@i.smu.edu.cn
  • 作者简介:李春萍（1998-）,女,广东湛江人,本科学历,硕士研究生在读。
  • 基金资助:
    瑞士发展与合作署（#81067392）

Interpretation of Normalization Process Theory—a Theory of Implementation Science

LI Chun-ping1a,1b, ZHANG Lan-ping1b, WANG Xiao-hui2, ZHONG Le-xin1b, YANG Wei3, ZHAO Qing1a,1b, LV Sen-sen1b, LI Jia-qi1b, XIE Yun-yun1b, HUANG Wan-qing1b, CHEN Xiao-shan1b, XU Dong1b,1c,4,1a   

  1. 1. Southern Medical University a.School of Public Health; b.Acacia Lab for Implementation Science, School of Health Management; c.Center for World Health Organization Studies and Department of Health Management, School of Health Management,Guangzhou 510515, China;
    2. School of Public Health, Lanzhou University, Lanzhou730000, China;
    3. School of Public Health, the key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 561113 China;
    4. Acacia Lab for Implementation Research, Southern Medical University Institute for Global Health, Dermatology Hospital of Southern Medical University, Guangzhou510515, China
  • Received:2023-12-15 Online:2024-03-10 Published:2024-04-08

PDF (PC)

175

赞

摘要： 目的 常态化过程理论（Normalization Process Theory,NPT）是实施研究中常用的理论之一,但较难理解。本文将详细介绍NPT,为研究者理解NPT提供指引。方法 通过检索与NPT理论相关的文献并结合团队实际使用NPT的体验,描述NPT的起源、开发与演变、核心要素解读、运用并讨论其特点。结果 NPT以新技术在日常工作中的嵌入（即常态化）为实施结局,指出这个结局是实施者、实施对象和实施环境相互作用的过程。经过20余年的演变,NPT最终包含4个维度和16个构念。结论 NPT逐步完善,为实施科学提供了重要的理论基础;但NPT比较抽象,且存在逻辑和概念的不足,研究者需要在透彻了解其含义的基础上灵活使用。

关键词: 常态化过程理论（NPT）, 实施科学, 实施研究, 循证实践

Abstract: Objective The Normalization Process Theory(NPT) is commonly utilized in implementation research but is often perceived as challenging to understand. This paper aims to offer a detailed introduction to NPT to assist researchers in comprehending its intricacies. Methods A meticulous literature review was conducted, and the findings were integrated with our firsthand experiences of applying NPT in our research. This approach facilitated the illustration of NPT's origin, evolution, components, and a discussion on its distinct attributes. Results NPT takes the embedding of new technology in daily work (i. e. normalization) as the implementation outcome, and that is the interaction between the implementer, the implementation object and the implementation environment. After more than 20 years of evolution, NPT eventually contained 4 domains and 16 constructs. Conclusion NPT has progressively developed and now provides a vital theoretical underpinning for the field of implementation science. Despite its importance, the theory's abstract nature and certain logical and conceptual limitations require that researchers apply it with flexibility and a deep understanding of its principles.

Key words: Normalization Process Theory (NPT), implementation science, implementation research, evidence-based medicine

中图分类号: 

  • R47
[1] Eccles MP, Mittman BS.Welcome to Implementation Science[J]. Implement Sci, 2006,1(1):1. DOI:10.1186/1748-5908-1-1.
[2] Nilsen P.Making sense of implementation theories, models and frameworks[J]. Implement Sci, 2015,10(1):53. DOI:10.1186/s13012-015-0242-0.
[3] Nilsen P.Overview of theories, models and frameworks in implementation science[M]. United Kingdom: Edward Elgar, 2020: 8-31. DOI:10.4337/9781788975995.
[4] Wang Y, Wong EL, Nilsen P, et al.A scoping review of implementation science theories, models, and frameworks - an appraisal of purpose, characteristics, usability, applicability, and testability[J]. Implement Sci, 2023,18(1):43. DOI:10.1186/s13012-023-01296-x.
[5] 张兰萍, 吕森森, 何文俊, 等. 实施性研究综合框架(CFIR)更新版的解析和应用[J]. 护理学报, 2023,30(11):47-52. DOI: 10.16460/j.issn1008-9969.2023.11.047.
[6] Peters S, Sukumar K, Blanchard S, et al.Trends in guideline implementation: an updated scoping review[J]. Implement Sci, 2022, 17(1): 50. DOI:10.1186/s13012-022-01223-6.
[7] Peters S, Sukumar K, Blanchard S, et al.Trends in guideline implementation: an updated scoping review[J]. Implement Sci, 2022,17(1):50. DOI:10.1186/s13012-022-01223-6.
[8] May C, Finch T.Implementing, embedding, and integrating practices: an outline of Normalization Process Theory[J]. Sociology,2009,43(3):535-554.DOI:10.1177/0038038509103208.
[9] May CR, Mair F, Finch T, et al.Development of a theory of implementation and integration:Normalization Process Theory[J]. Implement Sci, 2009,4(1):29.DOI:10.1186/1748-5908-4-29.
[10] May C.A rational model for assessing and evaluating complex interventions in health care[J]. BMC Health Serv Res, 2006,6(1):86. DOI:10.1186/1472-6963-6-86.
[11] 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):80. DOI:10.1186/s13012-018-0758-1.
[12] May CR, Albers B, Bracher M, et al.Translational framework for implementation evaluation and research: a normalisation process theory coding manual for qualitative research and instrument development[J]. Implement Sci, 2022,17(1):19. DOI:10.1186/s13012-022-01191-x.
[13] Tierney E, McEvoy R, O’ Reilly-de BM, et al. A critical analysis of the implementation of service user involvement in primary care research and health service development using Normalization Process Theory[J]. Health Expect, 2016,19(3):501-515. DOI:10.1111/hex.12237.
[14] MAY C, Rapley T, Mair FS, et al.Normalization Process Theory on-line users’ manual, toolkit and NoMAD instrument[EB/OL].[2023-08-24].https://normalization-process-theory.northumbria.ac.uk/.
[15] McEvoy R, Ballini L, Maltoni S, et al. A qualitative systematic review of studies using the Normalization Process Theory to research implementation processes[J].Implement Sci, 2014,9(1):2. DOI:10.1186/1748-5908-9-2.
[16] May CR, Johnson M, Finch T.Implementation, context and complexity[J]. Implement Sci, 2016,11(1):141. DOI:10.1186/s13012-016-0506-3.
[17] May C.Towards a general theory of implementation[J]. Implement Sci, 2013,8(1):18 DOI:10.1186/1748-5908-8-18.
[1] 黄宇星, 刘宁, 黄婷. 基于核心能力构建适宜中低资源地区护理本科循证实践教学指标体系[J]. 护理学报, 2023, 30(13): 24-28.
[2] 张兰萍, 吕森森, 何文俊, 陈江芸, 蔡毅媛, 李春萍, 刘思源, 钟冬梅, 李嘉琪, 谢昀筠, 黄婉晴, 陈晓珊, 徐东. 实施性研究综合框架（CFIR）更新版的解析和应用[J]. 护理学报, 2023, 30(11): 47-52.
[3] 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.
[4] 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.
[5] 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.
[6] 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.
[7] 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.
[8] 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.
[9] 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.
[10] 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.
[11] 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.
[12] 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.
[13] 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.
[14] 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.
[15] 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.
Viewed
Full text


Abstract

Cited
  Shared   
[1] 卢康媛, 王洁, 陈玉蓓, 纪雪梅, 郑智慧. 基于群组分析的组织信任在护士信任患者与工作投入间的中介效应[J]. 护理学报, 2024, 31(5): 1 -6 .
[2] 段乃娟, 孙丽, 李凤侠, 张会. 基于二元应对的宫颈癌患者夫妻参与式绘画疗法干预方案构建研究[J]. 护理学报, 2024, 31(5): 7 -11 .
[3] 黄鑫, 余丽君, 张二明, 哈丽娜. 稳定期COPD患者的能量摄入现状及影响因素分析[J]. 护理学报, 2024, 31(5): 12 -16 .
[4] 胡晓涵, 占婷婷, 何望生, 乔疏桐, 李雪. 肝豆状核变性患者自我管理体验的质性研究[J]. 护理学报, 2024, 31(5): 17 -21 .
[5] 张明会, 张淼, 陈丽娟, 余满荣. 脱口秀科普作品创作在手术室护理临床教学中的应用[J]. 护理学报, 2024, 31(5): 22 -25 .
[6] 于鑫淼, 刘红霞, 岳树锦, 王芊鹭, 韩竹凤, 张淑萍. 基于OBE理念的“精神科护理学”课程思政教学改革研究[J]. 护理学报, 2024, 31(5): 26 -29 .
[7] 罗霞, 刘玉萍, 帅平, 关华, 杨华, 姚晓琴. 体检护士能力绩效考核方案的构建[J]. 护理学报, 2024, 31(5): 30 -33 .
[8] 吴觅之, 刘文生, 潘红英, 余红梅, 黄晨. 住院患者器械相关压力性损伤的数据挖掘及防范对策分析[J]. 护理学报, 2024, 31(5): 34 -38 .
[9] 吴林梅, 梁志金, 刘瑞杰, 钟静静, 邱予骅. COPD患者运动康复促进和阻碍因素的系统评价-基于CFIR多层次理论[J]. 护理学报, 2024, 31(5): 44 -49 .
[10] 邓悦, 胡宇帆, 王冉, 张远星, 王芳, 袁萍, 陈璐. 老年患者接受远程医疗护理体验与需求质性研究的Meta整合[J]. 护理学报, 2024, 31(5): 50 -55 .