Abstract:

Objective To analyze the definition of de-implementation，and provide a theoretical basis for research and clinical practice. Methods Pubmed，ProQuest，CINAHL，CNKI，Wanfang，VIP，and China Biomedical Literature Service System databases were searched. The search time limit was from the establishment of the database to July 2022. As a result，40 articles were selected for analysis. Walker and Avant′s methods were used to perform concept analysis of de-implementation in terms of its definition，pre-factors，post-results. Results De-implementation can be classified into 4 defined attributes：low-value care as the subjects；strategies to apply；4 types of removing，replacing，reducing，restricting；complicated process. The pre-factors can be discussed from the aspects of low-value care，health care systems，patients，ethical and social factors. De-implementation can impact to patients and health care systems. Conclusions The research on de-implementation is still at an early stage. There is a lack of relevant measurement tools for the accurate determination of de-implementation. In the future，research and clinical practice should be carried out based on the concept of de-implementation.

Key words: De-Implementation, Concept Analysis, Health Care System, Nursing Care

摘要：

目的 分析“去实施”的定义和内涵，为“去实施”的研究和临床实践提供理论基础。方法 系统检索PubMed、ProQuest、CINAHL、中国知网、中国生物医学文献服务系统、维普数据库、万方数据库中“去实施”的相关文献，检索时限为建库至2022年7月。最终纳入文献40篇。采用Walker和Avant概念分析法进行概念分析，从“去实施”的定义属性、前置因素、后置影响等方面进行分析和整合。结果 “去实施”包括以低价值护理为对象、使用相应的策略、包含4种类型和过程复杂4个定义属性；前置因素包含低价值护理因素、卫生保健服务系统因素、患者因素、伦理因素和社会因素；后置影响包括对患者的影响和对卫生保健系统的影响。结论 目前“去实施”研究仍处于初级阶段，尚缺少相关测量工具，未来应基于“去实施”的内涵进行研究和开展临床实践。

关键词: 去实施, 概念分析, 卫生保健系统, 护理