To increase the likelihood of successful implementation of evidence-based practices, researchers, knowledge users, and healthcare professionals must consider aspects of context that promote and hinder implementation in their setting. The purpose of the current study was to identify contextual attributes and their features relevant to implementation by healthcare professionals and compare and contrast these attributes and features across different clinical settings and healthcare professional roles. We conducted a secondary analysis of 145 semi-structured interviews comprising 11 studies (10 from Canada and one from Australia) investigating healthcare professionals’ perceived barriers and enablers to their use of research evidence in clinical practice. The data was collected using semi-structured interview guides informed by the Theoretical Domains Framework across different healthcare professional roles, settings, and practices. We analyzed these data inductively, using constant comparative analysis, to identify attributes of context and their features reported in the interviews. We compared these data by (1) setting (primary care, hospital-medical/surgical, hospital-emergency room, hospital-critical care) and (2) professional role (physicians and residents, nurses and organ donor coordinators). We identified 62 unique features of context, which we categorized under 14 broader attributes of context. The 14 attributes were resource access, work structure, patient characteristics, professional role, culture, facility characteristics, system features, healthcare professional characteristics, financial, collaboration, leadership, evaluation, regulatory or legislative standards, and societal influences. We found instances of the majority (n = 12, 86%) of attributes of context across multiple (n = 6 or more) clinical behaviors. We also found little variation in the 14 attributes of context by setting (primary care and hospitals) and professional role (physicians and residents, and nurses and organ donor coordinators). There was considerable consistency in the 14 attributes identified irrespective of the clinical behavior, setting, or professional role, supporting broad utility of the attributes of context identified in this study. There was more variation in the finer-grained features of these attributes with the most substantial variation being by setting.

中文翻译：

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与医疗保健专业人员在临床实践中使用研究证据相关的背景属性：多项研究分析

为了增加成功实施循证实践的可能性，研究人员、知识用户和医疗保健专业人员必须考虑在其环境中促进和阻碍实施的环境因素。当前研究的目的是确定与医疗保健专业人员实施相关的背景属性及其特征，并比较和对比不同临床环境和医疗保健专业人员角色的这些属性和特征。我们对 145 次半结构化访谈进行了二次分析，其中包括 11 项研究（10 项来自加拿大，1 项来自澳大利亚），调查医疗保健专业人员在临床实践中使用研究证据的障碍和推动因素。这些数据是使用半结构化访谈指南收集的，该指南由理论领域框架提供，涉及不同的医疗保健专业角色、环境和实践。我们通过不断的比较分析对这些数据进行归纳分析，以确定访谈中报告的背景属性及其特征。我们通过（1）环境（初级保健、医院内科/外科、医院急诊室、医院重症监护）和（2）专业角色（医生和住院医师、护士和器官捐献协调员）对这些数据进行比较。我们确定了上下文的 62 个独特特征，并将其归类为 14 个更广泛的上下文属性。这 14 个属性是资源获取、工作结构、患者特征、专业角色、文化、设施特征、系统特征、医疗保健专业特征、财务、协作、领导力、评估、监管或立法标准以及社会影响。我们发现了多种（n = 6 或更多）临床行为中大多数（n = 12, 86%）背景属性的实例。我们还发现，不同环境（初级保健和医院）和专业角色（医生和住院医师、护士和器官捐献协调员）的 14 个背景属性几乎没有差异。无论临床行为、环境或专业角色如何，所确定的 14 个属性都具有相当大的一致性，支持本研究中确定的背景属性的广泛实用性。这些属性的更细粒度特征存在更多变化，其中最显着的变化是设置。