Developing initial programme theories for a realist synthesis on digital clinical consultations in maternity care: contributions from stakeholder involvement
Catrin Evans, Georgia Clancy, Kerry Evans, Andrew Booth, Benash Nazmeen, Stephen Timmons, Candice Sunney, Mark Clowes, Nia Wyn Jones, Helen Spiby- Research and Theory
Background:
The COVID pandemic prompted an increase in the use of digital clinical consultations (telephone or video calls) within midwifery and nursing care. This paper reports on a realist review project related to maternity care that seeks to illuminate for whom such consultations can safely and acceptably be used, how, for what purposes and in what contexts.
Aims:
This paper addresses the first phase of a realist enquiry – initial programme theory development – focusing particularly on the role of stakeholder involvement (including digital transformation leaders, midwives, obstetricians, service users and community organisations).
Methods:
Three sub-stages of initial programme theory development are described highlighting the contribution of stakeholder groups to each stage: (i) consultation to focus the review question, (ii) focused searching and (iii) further consultation.
Results:
Realist literature searching strategies yielded limited theory-rich evidence on digital consultations. Stakeholders provided essential additional contributions resulting in the development of 13 initial programme theories and a conceptual framework.
Conclusions:
More research on the implementation of virtual midwifery/nursing consultations is needed. Nursing/midwifery digital researchers should involve stakeholders to help shape research priorities, deepen contextual understanding and sense-check emerging findings.