| 1. |
- Seers, K., et al.
(författare)
-
Facilitating Implementation of Research Evidence (FIRE): An international cluster randomised controlled trial to evaluate two models of facilitation informed by the Promoting Action on Research Implementation in Health Services (PARIHS) framework
- 2018
-
Ingår i: Implementation Science. - : Springer Science and Business Media LLC. - 1748-5908. ; 13:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Health care practice needs to be underpinned by high quality research evidence, so that the best possible care can be delivered. However, evidence from research is not always utilised in practice. This study used the Promoting Action on Research Implementation in Health Services (PARIHS) framework as its theoretical underpinning to test whether two different approaches to facilitating implementation could affect the use of research evidence in practice. Methods: A pragmatic clustered randomised controlled trial with embedded process and economic evaluation was used. The study took place in four European countries across 24 long-term nursing care sites, for people aged 60years or more with documented urinary incontinence. In each country, sites were randomly allocated to standard dissemination, or one of two different types of facilitation. The primary outcome was the documented percentage compliance with the continence recommendations, assessed at baseline, then at 6, 12, 18, and 24months after the intervention. Data were analysed using STATA15, multi-level mixed-effects linear regression models were fitted to scores for compliance with the continence recommendations, adjusting for clustering. Results: Quantitative data were obtained from reviews of 2313 records. There were no significant differences in the primary outcome (documented compliance with continence recommendations) between study arms and all study arms improved over time. Conclusions: This was the first cross European randomised controlled trial with embedded process evaluation that sought to test different methods of facilitation. There were no statistically significant differences in compliance with continence recommendations between the groups. It was not possible to identify whether different types and "doses" of facilitation were influential within very diverse contextual conditions. The process evaluation (Rycroft-Malone et al., Implementation Science. doi: 10.1186/s13012-018-0811-0) revealed the models of facilitation used were limited in their ability to overcome the influence of contextual factors. © 2018 The Author(s).
|
|
| 2. |
|
|
| 3. |
|
|
| 4. |
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
|
|
| 8. |
- Rycroft-Malone, J., et al.
(författare)
-
A realist process evaluation within the Facilitating Implementation of Research Evidence (FIRE) cluster randomised controlled international trial: An exemplar
- 2018
-
Ingår i: Implementation Science. - : Springer Science and Business Media LLC. - 1748-5908. ; 13:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Facilitation is a promising implementation intervention, which requires theory-informed evaluation. This paper presents an exemplar of a multi-country realist process evaluation that was embedded in the first international randomised controlled trial evaluating two types of facilitation for implementing urinary continence care recommendations. We aimed to uncover what worked (and did not work), for whom, how, why and in what circumstances during the process of implementing the facilitation interventions in practice. Methods: This realist process evaluation included theory formulation, theory testing and refining. Data were collected in 24 care home sites across four European countries. Data were collected over four time points using multiple qualitative methods: observation (372h), interviews with staff (n=357), residents (n=152), next of kin (n=109) and other stakeholders (n=128), supplemented by facilitator activity logs. A combined inductive and deductive data analysis process focused on realist theory refinement and testing. Results: The content and approach of the two facilitation programmes prompted variable opportunities to align and realign support with the needs and expectations of facilitators and homes. This influenced their level of confidence in fulfilling the facilitator role and ability to deliver the intervention as planned. The success of intervention implementation was largely dependent on whether sites prioritised their involvement in both the study and the facilitation programme. In contexts where the study was prioritised (including release of resources) and where managers and staff support was sustained, this prompted collective engagement (as an attitude and action). Internal facilitators' (IF) personal characteristics and abilities, including personal and formal authority, in combination with a supportive environment prompted by managers triggered the potential for learning over time. Learning over time resulted in a sense of confidence and personal growth, and enactment of the facilitation role, which resulted in practice changes. Conclusion: The scale and multi-country nature of this study provided a novel context to conduct one of the few trial embedded realist-informed process evaluations. In addition to providing an explanatory account of implementation processes, a conceptual platform for future facilitation research is presented. Finally, a realist-informed process evaluation framework is outlined, which could inform future research of this nature. © 2018 The Author(s).
|
|
| 9. |
|
|
| 10. |
|
|
| 11. |
- Bergström, Anna, 1983-, et al.
(författare)
-
The use of the PARIHS framework in implementation research and practice-a citation analysis of the literature
- 2020
-
Ingår i: Implementation science : IS. - : Springer Science and Business Media LLC. - 1748-5908. ; 15:1
-
Forskningsöversikt (refereegranskat)abstract
- BACKGROUND: The Promoting Action on Research Implementation in Health Services (PARIHS) framework was developed two decades ago and conceptualizes successful implementation (SI) as a function (f) of the evidence (E) nature and type, context (C) quality, and the facilitation (F), [SI = f (E,C,F)]. Despite a growing number of citations of theoretical frameworks including PARIHS, details of how theoretical frameworks are used remains largely unknown. This review aimed to enhance the understanding of the breadth and depth of the use of the PARIHS framework. METHODS: This citation analysis commenced from four core articles representing the key stages of the framework's development. The citation search was performed in Web of Science and Scopus. After exclusion, we undertook an initial assessment aimed to identify articles using PARIHS and not only referencing any of the core articles. To assess this, all articles were read in full. Further data extraction included capturing information about where (country/countries and setting/s) PARIHS had been used, as well as categorizing how the framework was applied. Also, strengths and weaknesses, as well as efforts to validate the framework, were explored in detail. RESULTS: The citation search yielded 1613 articles. After applying exclusion criteria, 1475 articles were read in full, and the initial assessment yielded a total of 367 articles reported to have used the PARIHS framework. These articles were included for data extraction. The framework had been used in a variety of settings and in both high-, middle-, and low-income countries. With regard to types of use, 32% used PARIHS in planning and delivering an intervention, 50% in data analysis, 55% in the evaluation of study findings, and/or 37% in any other way. Further analysis showed that its actual application was frequently partial and generally not well elaborated. CONCLUSIONS: In line with previous citation analysis of the use of theoretical frameworks in implementation science, we also found a rather superficial description of the use of PARIHS. Thus, we propose the development and adoption of reporting guidelines on how framework(s) are used in implementation studies, with the expectation that this will enhance the maturity of implementation science.
|
|
| 12. |
|
|
| 13. |
|
|
| 14. |
|
|
| 15. |
- Eldh, Ann Catrine, 1965-, et al.
(författare)
-
Translating and testing the Alberta Context Tool for use among nurses in Swedish elder care
- 2013
-
Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 13
-
Tidskriftsartikel (refereegranskat)abstract
- Background. There is emerging evidence that context is important for successful transfer of research knowledge into health care practice. The Alberta Context Tool (ACT) is a Canadian developed research-based instrument that assesses 10 modifiable concepts of organizational context considered important for health care professionals’ use of evidence. Swedish and Canadian health care have similarities in terms of organisational and professional aspects, suggesting that the ACT could be used for measuring context in Sweden. This paper reports on the translation of the ACT to Swedish and a testing of preliminary aspects of its validity, acceptability and reliability in Swedish elder care.Methods. The ACT was translated into Swedish and back-translated into English before being pilot tested in ten elder care facilities for response processes validity, acceptability and reliability (Cronbach’s alpha). Subsequently, further modification was performed.Results. In the pilot test, the nurses found the questions easy to respond to (52%) and relevant (65%), yet the questions’ clarity were mainly considered ‘neither clear nor unclear’ (52%). Missing data varied between 0 (0%) and 19 (12%) per item, the most common being 1 missing case per item (15 items). Internal consistency (Cronbach’s Alpha > .70) was reached for 5 out of 8 contextual concepts. Translation and back translation identified 21 linguistic- and semantic related issues and 3 context related deviations, resolved by developers and translators.Conclusion. Modifying an instrument is a detailed process, requiring time and consideration of the linguistic and semantic aspects of the instrument, and understanding of the context where the instrument was developed and where it is to be applied. A team, including the instrument’s developers, translators, and researchers is necessary to ensure a valid translation. This study suggests preliminary validity, reliability and acceptability evidence for the ACT when used with nurses in Swedish elder care.
|
|
| 16. |
|
|
| 17. |
|
|
| 18. |
- Eldh, Sigrid, et al.
(författare)
-
Towards a Test Automation Improvement Model (TAIM)
- 2014
-
Ingår i: Proc. - IEEE Int. Conf. Softw. Test., Verif. Valid. Workshops, ICSTW. - : IEEE Press. - 9780769551944 ; , s. 337-342, s. 337-342
-
Konferensbidrag (refereegranskat)abstract
- In agile software development, industries are becoming more dependent on automated test suites. Thus, the test code quality is an important factor for the overall system quality and maintainability. We propose a Test Automation Improvement Model (TAIM) defining ten key areas and one general area. Each area should be based on measurements, to fill the gap of existing assessments models. The main contribution of this paper is to provide the outline of TAIM and present our intermediate results and some initial metrics to support our model. Our initial target has been the key area targeting implementation and structure of test code. We have used common static measurements to compare the test code and the source code of a unit test automation suite being part of a large complex telecom subsystem. Our intermediate results show that it is possible to outline such an improvement model and our metrics approach seems promising. However, to get a generic useful model to aid test automation evolution and provide for comparable measurements, many problems still remain to be solved. TAIM can as such be viewed as a framework to guide the research on metrics for test automation artifacts.
|
|
| 19. |
|
|
| 20. |
- Hälleberg Nyman, Maria, 1968-, et al.
(författare)
-
Identifying the knowledge to translate : the example of urinary incontinence in older people
- 2015
-
Ingår i: Nordic Conference on Implementation of Evidence-Based Practice.
-
Konferensbidrag (refereegranskat)abstract
- Background: While urinary incontinence (UI) is a common and worrying issue among older people, promoting the use of evidence to prevent UI onset has rarely been studied. An earlier study that was conducted in nursing homes suggests that UI can be better assessed and managed, but the prevention of UI onset requires attention to the issue by staff within acute care settings. Aim: To report on the internal facilitators’ (IF) transition, identifying the 'know-do gap' between evidence and practice in UI prevention in orthopaedic care.Methods: The Onset PrevenTion of Incontinence in Orthopaedic Nursing and rehabilitation (OPTION) pilot was carried out in two Swedish orthopaedic units of different size and location. The pilot project included a programme to support nursing and rehab staff to facilitate knowledge translation (KT). Five IFs were interviewed at baseline, and one and three months after the intervention was completed, and non-participant observations were performed during the KT-intervention. Interviews and observations were triangulated, depicting when and how the IFs identified the present, local UI practice, the evidence on UI, and the know-do gap in preventing UI onset in older patients undergoing hip surgery.Results: Preliminary results indicate that before the study, neither the IFs nor their fellows at the units were aware that they could prevent UI onset. Rather, through mapping their context and matching the evidence provided by the dialogue with the experts in the KTintervention, the IFs became aware of which practice was evidence based and which evidence to implement, and how to facilitate KT and promote evidence use.Conclusion: The OPTION pilot indicates that KT can be promoted by tailored implementation strategies and tailoring evidence, supported by IFs awareness and understanding of the local know-do gap, and strategies to overcome barriers and promote use of evidence.
|
|
| 21. |
- Jagemar, Marcus, et al.
(författare)
-
Adaptive online feedback controlled message compression
- 2014
-
Ingår i: Proceedings - International Computer Software and Applications Conference. - 9781479935741 ; , s. 558-567
-
Konferensbidrag (refereegranskat)abstract
- Communication is a vital part of computer systems today. One current problem is that computational capacity is growing faster than the bandwidth of interconnected computers. Maximising performance is a key objective for industries, both on new and existing software systems, which further extends the need for more powerful systems at the cost of additional communication. Our contribution is to let the system selectively choose the best compression algorithm from a set of available algorithms if it provides a better overall system performance. The online selection mechanism can adapt to a changing environment such as temporary network congestion or a change of message content while still selecting the optimal algorithm. Additionally, is autonomous and does not require any human intervention making it suitable for large-scale systems. We have implemented and evaluated this autonomous selection and compression mechanism in an initial trial situation as a proof of concept. The message round trip time were decreased by 7.1%, while still providing ample computational resources for other co-existing services.
|
|
| 22. |
- Jerofke-Owen, Teresa A., et al.
(författare)
-
Patient engagement, involvement, or participation - entrapping concepts in nurse-patient interactions : A critical discussion
- 2023
-
Ingår i: Nursing Inquiry. - : John Wiley & Sons. - 1320-7881 .- 1440-1800. ; 30:1
-
Tidskriftsartikel (refereegranskat)abstract
- The importance of patients taking an active role in their healthcare is recognized internationally, to improve safety and effectiveness in practice. There is still, however, some ambiguity about the conceptualization of that patient role; it is referred to interchangeably in the literature as engagement, involvement, and participation. The aim of this discussion paper is to examine and conceptualize the concepts of patient engagement, involvement, and participation within healthcare, particularly nursing. The concepts were found to have semantic differences and similarities, although, from a nursing perspective, they can be summoned to illustrate the establishment of a mutual partnership between a patient and a nurse. The individualization of such processes requires the joint effort of engagement, involvement, or participation, represented by interactive actions of both the patient (asking questions, telling/speaking up, knowledge acquisition, learning, and decision-making) and the nurse (recognizing, responding, information sharing, teaching, and collaborating). Suggesting that the concepts can be used interchangeably comes with some caution, requiring that nurses embrace patients playing a role in their health and healthcare. Further research and practice development should focus on how patients and nurses receive and respond to each other to establish patient engagement, involvement, and participation.
|
|
| 23. |
- Kvael, Linda A. H., et al.
(författare)
-
Preference-based patient participation in intermediate care : Translation, validation and piloting of the 4Ps in Norway
- 2024
-
Ingår i: Health Expectations. - : John Wiley & Sons. - 1369-6513 .- 1369-7625. ; 27:1
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: The implementation and evaluation of patient participation to obtain high-quality transitional care for older people is an international priority. Intermediate care (IC) services are regarded as an important part of the patient's pathway from the specialist to the primary care levels, bridging the gap between the hospital and the home. Patients may experience varying capacities and conditions for patient participation. Yet, few tools for evaluating patients' preferences for patient participation within IC services are at hand. Accordingly, further knowledge is needed to understand and scaffold processes for patient participation in IC. Therefore, the aim of this project was to translate, validate and pilot test the Patient Preferences for Patient Participation (the 4Ps) with patients in IC services in Norway.Methods: This project comprised two phases: (1) a careful translation and cultural adaptation process, followed by a content validity trial among 15 patients and staff in Norwegian IC and (2) a cross-sectional survey of the instrument with 60 patients admitted to IC.Results: The translation between Swedish and Norwegian required no conceptual or contextual adaptations. The subsequent cross-sectional study, designed as a dialogue between the patients and staff, revealed that only 50% of the participants received a sufficient level of patient participation based on their preferences, mostly indicating that patients were receiving less-than-preferred conditions for engaging in their health and healthcare issues.Conclusion: The 4Ps instrument was deemed suitable for measuring patient participation based on patient preferences in the IC context and was feasible for both healthcare professionals and patients to complete in an interview when arriving at and leaving services. This may support person-centred communication and collaboration, calling for further research on what facilitates patient participation and the implementation of person-centred services for patients in IC.Patient or Public Contribution: First, the current paper is part of the IPIC study (i.e., the implementation of patient participation in IC). Influenced by a James Lind Alliance process, the study addresses research uncertainties identified by patients, next of kin, staff and researchers in the cocreation process. Second, cognitive interviewing was conducted with 15 representatives of the target population: seven patients receiving IC services, one home-dwelling previous IC patient (altogether four women and four men, most of them 80 years or older) and seven healthcare staff working in IC services. The interviews determined the relevance, comprehensiveness and clarity of the 4Ps. Finally, 60 patients admitted to IC took part in the cross-sectional study.
|
|
| 24. |
|
|
| 25. |
|
|
| 26. |
|
|
| 27. |
- Nair, A., et al.
(författare)
-
Leveraging mutants for automatic prediction of metamorphic relations using machine learning
- 2019
-
Ingår i: MaLTeSQuE 2019 - Proceedings of the 3rd ACM SIGSOFT International Workshop on Machine Learning Techniques for Software Quality Evaluation, co-located with ESEC/FSE 2019. - New York, NY, USA : Association for Computing Machinery, Inc. - 9781450368551 ; , s. 1-6
-
Konferensbidrag (refereegranskat)abstract
- An oracle is used in software testing to derive the verdict (pass/fail) for a test case. Lack of precise test oracles is one of the major problems in software testing which can hinder judgements about quality. Metamorphic testing is an emerging technique which solves both the oracle problem and the test case generation problem by testing special forms of software requirements known as metamorphic requirements. However, manually deriving the metamorphic requirements for a given program requires a high level of domain expertise, is labor intensive and error prone. As an alternative, we consider the problem of automatic detection of metamorphic requirements using machine learning (ML). For this problem we can apply graph kernels and support vector machines (SVM). A significant problem for any ML approach is to obtain a large labeled training set of data (in this case programs) that generalises well. The main contribution of this paper is a general method to generate large volumes of synthetic training data which can improve ML assisted detection of metamorphic requirements. For training data synthesis we adopt mutation testing techniques. This research is the first to explore the area of data augmentation techniques for ML-based analysis of software code. We also have the goal to enhance black-box testing using white-box methodologies. Our results show that the mutants incorporated into the source code corpus not only efficiently scale the dataset size, but they can also improve the accuracy of classification models.
|
|
| 28. |
|
|
| 29. |
- Orton, M. L., et al.
(författare)
-
Nursing management matters for registered nurses with a PhD working in clinical practice
- 2019
-
Ingår i: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 27:5, s. 955-962
-
Tidskriftsartikel (refereegranskat)abstract
- AimTo investigate what registered nurses (RNs) with a PhD working in clinical practice experience in terms of their role, function and work context. BackgroundPrevious studies have shown that RNs with a graduate degree contribute to better and safer care for patients. However, little is known about what further academic schooling of RNs, at PhD level, means for clinical practice. MethodQualitative design, with semi-structured interviews and inductive content analysis. ResultsThe main areas of responsibilities for RNs with a PhD working in clinical practice were related to practice development and implementation of research results. In their work, they experienced barriers to the full use of their competence; the expectations and prerequisites of the organisation were not clearly defined, and they often lacked a mandate to create conditions for quality improvement of nursing care. ConclusionsRNs with a PhD can contribute to evidence-based practice (EBP), clinical training, as well as the development of clinical research. Their roles and responsibilities need to be clarified, and for this, they need support from managers. Implications for Nursing ManagementNurse managers have the opportunity to partner with RNs with a PhD to support the EBP process and help structure nursing practice in more efficient ways.
|
|
| 30. |
- Seers, Kate, et al.
(författare)
-
FIRE (Facilitating Implementation of Research Evidence) : a study protocol
- 2012
-
Ingår i: Implementation Science. - : BioMed Central (BMC). - 1748-5908. ; 7:25
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Research evidence underpins best practice, but is not always used in healthcare. The Promoting Action on Research Implementation in Health Services (PARIHS) framework suggests that the nature of evidence, the context in which it is used, and whether those trying to use evidence are helped (or facilitated) affect the use of evidence. Urinary incontinence has a major effect on quality of life of older people, has a high prevalence, and is a key priority within European health and social care policy. Improving continence care has the potential to improve the quality of life for older people and reduce the costs associated with providing incontinence aids. OBJECTIVES: This study aims to advance understanding about the contribution facilitation can make to implementing research findings into practice via: extending current knowledge of facilitation as a process for translating research evidence into practice; evaluating the feasibility, effectiveness, and cost-effectiveness of two different models of facilitation in promoting the uptake of research evidence on continence management; assessing the impact of contextual factors on the processes and outcomes of implementation; and implementing a pro-active knowledge transfer and dissemination strategy to diffuse study findings to a wide policy and practice community. SETTING AND SAMPLE: Four European countries, each with six long-term nursing care sites (total 24 sites) for people aged 60 years and over with documented urinary incontinence METHODS AND DESIGN: Pragmatic randomised controlled trial with three arms (standard dissemination and two different programmes of facilitation), with embedded process and economic evaluation. The primary outcome is compliance with the continence recommendations. Secondary outcomes include proportion of residents with incontinence, incidence of incontinence-related dermatitis, urinary tract infections, and quality of life. Outcomes are assessed at baseline, then at 6, 12, 18, and 24 months after the start of the facilitation interventions. Detailed contextual and process data are collected throughout, using interviews with staff, residents and next of kin, observations, assessment of context using the Alberta Context Tool, and documentary evidence. A realistic evaluation framework is used to develop explanatory theory about what works for whom in what circumstances. TRIAL REGISTRATION: Current Controlled Trials ISRCTN11598502.
|
|
