Realist synthesis: illustrating the method for implementation research

摘要: Realist synthesis is an increasingly popular approach to the review and of evidence, which focuses on understanding mechanisms by intervention works (or not). There are few published examples realist synthesis. This paper therefore fills a gap describing, in detail, process used for answer question ‘what interventions strategies effective enabling evidence-informed healthcare?’ The strengths challenges conducting also considered. involves identifying underlying causal exploring how they work under what conditions. stages this included: defining scope (concept mining framework formulation); searching scrutinising evidence; extracting synthesising developing narrative, including hypotheses. Based key terms concepts related various promote healthcare, we developed outcome-focused theoretical framework. Questions were tailored each four theory/intervention areas within guide development data extraction process. search literature our first theory area, change agency, was executed screening procedure resulted inclusion 52 papers. Using questions relevant extracted one reviewer validated second reviewer. Synthesis involved organisation into evidence tables, theming formulation chains inference, linking between hypothesis formulation. narrative around hypotheses generated agency area. lends itself complex because it accounts context as well outcomes systematically transparently literature. While demands flexible thinking ability deal with complexity, rewards include potential more pragmatic conclusions than alternative approaches systematic reviewing. A separate publication will report findings review.