tailieunhanh - báo cáo khoa học: " What work has to be done to implement collaborative care for depression? Process evaluation of a trial utilizing the Normalization Process Model"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: What work has to be done to implement collaborative care for depression? Process evaluation of a trial utilizing the Normalization Process Model | Gask et al. Implementation Science 2010 5 15 http content 5 1 15 Implementation Science IMPLEMENTATION SCIENCE RESEARCH ARTICLE Open Access What work has to be done to implement collaborative care for depression Process evaluation of a trial utilizing the Normalization Process Model Linda Gask 1 Peter Bower1 Karina Lovell2 Diane Escott2 Janine Archer2 Simon Gilbody3 Annette J Lankshear4 Angela E Simpson3 David A Richards5 Abstract Background There is a considerable evidence base for collaborative care as a method to improve quality of care for depression but an acknowledged gap between efficacy and implementation. This study utilises the Normalisation Process Model NPM to inform the process of implementation of collaborative care in both a future full-scale trial and the wider health economy. Methods Application of the NPM to qualitative data collected in both focus groups and one-to-one interviews before and after an exploratory randomised controlled trial of a collaborative model of care for depression. Results Findings are presented as they relate to the four factors of the NPM interactional workability relational integration skill-set workability and contextual integration and a number of necessary tasks are identified. Using the model it was possible to observe that predictions about necessary work to implement collaborative care that could be made from analysis of the pre-trial data relating to the four different factors of the NPM were indeed borne out in the post-trial data. However additional insights were gained from the post-trial interview participants who unlike those interviewed before the trial had direct experience of a novel intervention. The professional freedom enjoyed by more senior mental health workers may work both for and against normalisation of collaborative care as those who wish to adopt new ways of working have the freedom to change their practice but are not obliged to do so. Conclusions The NPM provides a