Abstract:

Objective To search and summarize the de-implementation strategy of low-value care and describe the specific elements of de-implementation strategies. Methods PubMed，ProQuest，CINAHL，China Biomedical Literature Service System database，CNKI，Wanfang and VIP database were searched until May 10，2023. Literature of de-implementation strategies was screened. Specific elements of the de-implementation strategies （i.e.，actors，actions，temporality，dose，action target，affected implementation outcome and justification） were extracted. Results A total of 20 pieces of the literature were included，of which 18 used multiple strategies and 2 used single strategy. A total of 65 strategies were extracted，and the education strategy was applied 15 times，the assessment and feedback strategy were applied 14 times，and the specific elements of only 3 strategies were fully described. Conclusion Education，assessment and feedback strategies are commonly used in de-implementation of low-value care studies. Future studies should clearly describe the specific elements of de-implementation strategies，in order to promote replication，improvement，and clinical application of strategies.

Key words: Low-Value Care, De-Implementation, Strategies, Scoping Review

摘要：

目的 对低价值护理“去实施”策略的相关研究进行范围综述，总结低价值护理“去实施”的策略及具体要素。方法 计算机检索PubMed、ProQuest、CINAHL、中国生物医学文献数据库、中国知网、万方数据库和维普数据库，检索时限为建库至2023年5月10日。筛选低价值护理“去实施”策略的文献，对文献中“去实施”策略及策略的具体要素，即执行者/制订者、操作性定义、时间性、强度、目标、受影响的结局指标和理由进行资料提取。结果 共纳入20篇文献，其中18篇使用了多种策略结合应用的方式，2篇使用了单一策略。共65个策略被提取，教育培训策略被应用15次，评估和反馈策略被应用14次，仅3个策略的具体要素被完整描述。结论 评估和反馈、教育培训策略是低价值护理“去实施”研究中常被应用的策略，未来研究应清晰描述“去实施”策略的具体要素，以促进策略的复制、改进和临床应用。

关键词: 低价值护理, 去实施, 策略, 范围综述