METHODS: A systematic literature review of quantitative, qualitative, and mixed methods research was undertaken using PubMed, MEDLINE, Embase, CINAHL, and Cochrane Library. Studies that reported barriers or/and facilitators to pressure injury prevention in the acute care settings and published in English from 2008 to 2022 were included. Studies were excluded if they were conducted in residential care facilities and nursing homes, or other long-term community care settings. Two authors independently screened articles against the inclusion and exclusion criteria. Quality appraisal was conducted by two authors by using the Mixed Methods Appraisal Tool. Reported results were mapped to the Theoretical Domains Framework to identify the barriers and facilitators to pressure injury prevention.
RESULTS: A total of 78 studies were included. There were 65 quantitative studies, 11 qualitative studies, and two mix-methods studies. The most salient Theoretical Domains Framework domains identified in this review were \"Knowledge\", \"Skills\", \"Environmental Context and Resources\", \"Optimism\", \"Social/Professional Role and Identity\", and \"Social influences\".
CONCLUSIONS: The barriers and facilitators to pressure injury prevention in hospital settings identified in this systematic review were diverse, and included issues at both individual and organizational level. Healthcare organizations can address the barriers and facilitators from the influential Theoretical Domains Framework domains. Future research is required to investigate the effectiveness of behaviour change interventions that specifically target these barriers and facilitators to pressure injury prevention.
方法:定量的系统文献综述,定性,混合方法研究是使用PubMed进行的,MEDLINE,Embase,CINAHL,科克伦图书馆研究报告了在急性护理环境中预防压力伤害的障碍或/和促进因素,并在2008年至2022年期间以英文发表。如果研究是在住宅护理设施和疗养院进行的,则被排除在外,或其他长期社区护理环境。两位作者根据纳入和排除标准独立筛选文章。由两位作者使用混合方法评价工具进行质量评价。报告的结果被映射到理论领域框架,以确定压力伤害预防的障碍和促进因素。
结果:共纳入78项研究。有65项定量研究,11项定性研究,和两种混合方法研究。本综述中确定的最突出的理论域框架域是“知识”,\"技能\",“环境背景和资源”,\"乐观\",“社会/职业角色和身份”,和“社会影响”。
结论:本系统综述中确定的医院环境中压力性损伤预防的障碍和促进因素是多种多样的,并包括个人和组织层面的问题。医疗保健组织可以解决有影响力的理论域框架领域的障碍和促进者。未来的研究需要调查行为改变干预措施的有效性,这些干预措施专门针对这些障碍和促进者进行压力伤害预防。