METHODS: This study was conducted according to the JBI methodological approach for scoping reviews. Searches were conducted in Medline (OVID-SP), Embase (OVID-SP), PsycINFO (OVID-SP), CINHAL (EBSCO), Scopus (Elsevier) and Web of Science (Clarivate) for relevant peer-reviewed publications up to May 2023. Screening, full-text review and data extraction were completed by two independent reviewers. Data were extracted and mapped to the TDF to identify relevant barriers and facilitators.
RESULTS: The search yielded 1057 publications, with 21 meeting the inclusion criteria. Mapping data to the TDF, the most frequently identified domains were (a) environmental context and resources, (b) skills, (c) knowledge and (d) emotion. Predominant factors impacting on implementation included practitioners\' lack of awareness about health assessments and their identified benefits; inadequate training and experience by practitioners in the delivery of health assessments for people with intellectual disability; insufficient time to provide health assessments; and practitioner burnout.
CONCLUSIONS: Using a theory-informed behavioural framework, our review aids understanding of the barriers and facilitators to improving the implementation of health assessments as part of routine care for people with intellectual disability. However, there is a clear need for further qualitative research to examine the perceptions of primary care practitioners regarding implementation barriers and facilitators to health assessments in general, including views from practitioners who are not currently undertaking health assessments.
方法:本研究是根据JBI方法学方法进行范围审查的。搜索在Medline(OVID-SP)进行,Embase(OVID-SP),PsycINFO(OVID-SP),CINHAL(EBSCO),Scopus(Elsevier)和WebofScience(Clarivate)提供截至2023年5月的相关同行评审出版物。筛选,全文审阅和数据提取由两名独立审阅者完成.数据被提取并映射到TDF以识别相关的障碍和促进者。
结果:搜索产生了1057种出版物,21人符合纳入标准。将数据映射到TDF,最常识别的领域是(A)环境背景和资源,(b)技能,(c)知识和(d)情感。影响实施的主要因素包括从业人员对健康评估及其已确定的益处缺乏认识;从业人员在为智障人士提供健康评估方面的培训和经验不足;提供健康评估的时间不足;以及从业人员倦怠。
结论:使用基于理论的行为框架,我们的审查有助于理解作为智障人士常规护理的一部分,改善健康评估实施的障碍和促进因素.然而,显然需要进一步的定性研究,以检查初级保健从业人员对实施障碍和促进者的总体健康评估的看法,包括目前没有进行健康评估的从业者的意见。