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Table 1 Clarify scope (Step 1) in the realist review process guided by Pawson et al. (2005)

From: Using technology to engage hospitalised patients in their care: a realist review

Key step Considerations/sub-steps Actions for current review
Identify review question Nature and content of the intervention Interventions using technology, available at the bedside, to engage patients in their hospital care for management or prevention of a health concern were the focus of this review. The initial review questions were ‘What are the features of successful interventions using technology to engage hospitalised patients in their health care?; Why are these features important?; and In what contexts do they work?’
Circumstances or context for its use
Refine purpose of review Theory integrity: does the intervention work as predicted? Authors’ theories for why interventions worked were identified and evaluated in an initial exploratory search of the literature. The theorised mechanisms of action in studies were evaluated to identify those that seemed to result in patient engagement in care. Intervention strategies and underlying mechanisms of action were compared among different settings and patient populations to identify what worked for whom under what conditions.
Theory adjudication: which theories fit best?
Comparison: how does the intervention work in different settings, for different groups?
Articulate key theories to be explored Draw up a ‘long list’ of relevant programme theories by exploratory searching An initial exploratory search of the literature, for the explicit purpose of identifying ‘the theories, the hunches, the expectations, the rationales and the rationalisations for why the intervention might work’ was conducted. Theories behind why interventions worked were collected from a number of papers and put into a ‘long list’ of key intervention theories. These were grouped into categories based on similarity; this formed a basic, provisional model (which was later refined) to help focus the literature search and guide initial data extraction.
Group, categories and synthesise theories
Design a theoretically based evaluative framework to be ‘populated’ with evidence