BACKGROUND Normalisation Process Theory (NPT) provides a framework to understand how interventions are implemented, embedded, and integrated in healthcare settings. Previous reviews of published literature have examined the application of NPT across international healthcare and reports its benefits. However, given the distinctive clinical function, organisational arrangements and the increasing management of people with a wide variety of conditions in primary care settings in the United Kingdom, it is important to understand how and why authors utilise and reflect on NPT in such settings to inform and evaluate implementation processes. METHODS A systematic review of peer-reviewed literature using NPT in primary care settings in the United Kingdom (UK) was conducted. Eight electronic databases were searched using replicable methods to identify articles published between January 2012 and April 2018. Data were analysed using a framework approach. RESULTS Thirty-one articles met the inclusion criteria. Researchers utilised NPT to explore the implementation of interventions, targeting a wide range of health services and conditions, within primary care settings in the UK. NPT was mostly applied qualitatively; however, a small number of researchers have moved towards mixed and quantitative methods. Some variation was observed in the use of NPT constructs and sub-constructs, and whether and how researchers undertook modification to make them more relevant to the implementation process and multiple stakeholder perspectives. CONCLUSION NPT provides a flexible framework for the development and evaluation of complex healthcare interventions in UK primary care settings. This review updates the literature on NPT use and indicates that its application is well suited to these environments, particularly in supporting patients with long-term conditions and co-morbidities. We recommend future research explores the receipt of interventions by multiple stakeholders and suggest that authors reflect on justifications for using NPT in their reporting.

中文翻译：

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规范化过程理论在理解英国基层医疗机构实施过程中的应用：系统综述。

背景技术归一化过程理论（NPT）提供了一个框架，以了解如何在医疗机构中实施，嵌入和集成干预措施。先前对已发表文献的评论已经研究了NPT在国际医疗保健中的应用并报告了其益处。但是，鉴于英国的初级保健机构具有独特的临床功能，组织安排以及对各种疾病患者的管理日益严格，因此，重要的是要了解作者如何以及为何在此类机构中利用和反思《不扩散核武器条约》以提供信息。并评估实施过程。方法对英国（UK）在初级保健机构中使用NPT的同行评审文献进行了系统综述。使用可复制的方法搜索了八个电子数据库，以识别2012年1月至2018年4月之间发表的文章。使用框架方法分析数据。结果共有31篇文章符合纳入标准。研究人员利用《不扩散条约》在英国的初级保健机构中探索针对各种卫生服务和条件的干预措施的实施。《不扩散核武器条约》大多定性适用；但是，少数研究人员已转向混合和定量方法。在使用《不扩散核武器条约》结构和子结构以及研究人员是否以及如何进行修改以使其与实施过程和利益相关者的多种观点更加相关方面，观察到了一些差异。结论NPT为英国初级保健机构中复杂的医疗干预措施的开发和评估提供了灵活的框架。这篇评论更新了有关NPT使用的文献，并指出其应用非常适合这些环境，特别是在支持患有长期疾病和合并症的患者中。我们建议未来的研究探索多个利益相关者的干预措施，并建议作者考虑在其报告中使用《不扩散核武器条约》的理由。