scholarly journals Factors influencing allied health professionals’ implementation of upper limb sensory rehabilitation for stroke survivors: a qualitative study to inform knowledge translation

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e042879
Author(s):  
Liana S Cahill ◽  
Leeanne M Carey ◽  
Yvonne Mak-Yuen ◽  
Annie McCluskey ◽  
Cheryl Neilson ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Qualitative Study ◽  
Knowledge Translation ◽  
Upper Limb ◽  
Occupational Therapists ◽  
Practice Change ◽  
Normalisation Process Theory ◽  
Evidence Based ◽  
Implementation Theory ◽  
Factors Influencing

ObjectivesSomatosensory loss is common after stroke with one-in-two individuals affected. Although clinical practice guidelines recommend providing somatosensory rehabilitation, this impairment often remains unassessed and untreated. To address the gap between guideline recommendations and clinical practice, this study sought to understand the factors influencing delivery of evidence-based upper limb sensory rehabilitation after stroke.DesignQualitative study involving focus groups and interviews. Data analysis used an inductive approach (thematic analysis) and deductive analysis using implementation theory (the Theoretical Domains Framework and Normalisation Process Theory).SettingEight healthcare organisations in metropolitan and regional areas of Victoria and New South Wales, Australia.ParticipantsEighty-seven rehabilitation therapists (79% occupational therapists and 21% physiotherapists) were purposively sampled and participated in a knowledge translation study with staggered recruitment from 2014 to 2018.ResultsThree types of factors influenced therapists’ delivery of upper limb somatosensory rehabilitation: individual (‘The uncertain, unskilled therapist’), patient (‘Patient understanding and priorities’) and organisational (‘System pressures and resources’). Deductive analysis using implementation theory identified key determinants of practice change, such as opportunities to consolidate new skills, the anticipated benefits of upskilling as a therapy team and the work anticipated by therapists to incorporate a new somatosensory rehabilitation approach.ConclusionsOccupational therapists and physiotherapists hold valuable insights towards practice change in somatosensory rehabilitation from the ‘frontline’. Therapists experience barriers to change including a lack of knowledge and skills, lack of resources and organisational pressures. Facilitators for change were identified, including social support and therapists’ perceived legitimacy in using new somatosensory rehabilitation approaches. Results will inform the design of a tailored implementation strategy to increase the use of evidence-based somatosensory rehabilitation in Australia.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12615000933550).

A Knowledge Translation Framework for Optimizing Physical Therapy in Patients With Heart Failure

2021 ◽  
Author(s):  
Konrad J Dias ◽  
Michael J Shoemaker ◽  
Kristin M Lefebvre ◽  
John D Heick
Keyword(s):  
Heart Failure ◽  
Clinical Practice ◽  
Physical Therapy ◽  
Knowledge Translation ◽  
Cardiorespiratory Fitness ◽  
Practice Guideline ◽  
Physical Therapist ◽  
Evidence Based ◽  
Patients With Heart Failure ◽  
The Continuum

Abstract The American Physical Therapy Association (APTA) has supported the development of clinical practice guidelines to promote and support evidence-based practice and reduce unwarranted practice variation. Essential to the success of this effort is the generation of knowledge translation—a concept that emphasizes the translation of global knowledge to an application that can be effectively integrated into clinical practice. The Physical Therapy Clinical Practice Guideline for the Management of Individuals with Heart Failure published in the Physical Therapy Journal in January 2020 provides a broad base of knowledge related to evidence-based treatment interventions for patients with heart failure. However, the application and integration of this knowledge in clinical practice need further elucidation. Therefore, this perspective paper aims to serve as a complementary knowledge translation resource to the recently published practice guideline to maximize the utilization of contemporary evidence in clinical practice. This resource provides the physical therapist with practical guidance in the management of patients with heart failure by placing research findings in the context of other knowledge and practice norms that can be applied at the point of care and across the continuum of care. We propose a novel ABCDE (Assessment, Behavior, Cardiorespiratory Fitness, Dosage, and Education) practical framework. This clinical paradigm is grounded in ongoing physical therapist assessment throughout the episode of care, along with behavior modification, assessment of cardiorespiratory fitness, appropriate selection and dosing of interventions and patient education. Examples highlighting the use of this model in patients with heart failure across the continuum of care are provided for application in clinical care.

scholarly journals A Qualitative Study to Explore Ways to Observe Results of Engaging Activities in Clients with Dementia

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Masahiro Ogawa ◽  
Seiji Nishida ◽  
Haruna Shirai
Keyword(s):  
Cognitive Impairment ◽  
Clinical Practice ◽  
Social Interaction ◽  
Qualitative Study ◽  
Emotional Expression ◽  
Occupational Therapists ◽  
Verbal Expression ◽  
Future Studies ◽  
Severity Of Dementia ◽  
Depth Interviews

Background. Many occupational therapists face the challenge of helping clients with dementia to select and perform meaningful occupations, which may be difficult due to cognitive impairment. Understanding tacit knowledge of well-experienced occupational therapists could positively affect occupational therapy practice for clients with dementia. Objectives of Study. To explore the observations of experienced occupational therapists when evaluating the effects of activities in clients with dementia. Methods. Ten occupational therapists with over 10 years of clinical experience participated in this qualitative study. In-depth interviews were conducted to ask the question, “What do you observe in clients with dementia when you assess the effectiveness of activities among these clients?” Findings. From 47 cases, we found five major themes and 18 subthemes. Main themes were “engaging activity,” “emotional expression during activity,” “verbal expression during activity,” “social interaction through activity,” and “something obtained as outcome of activity.” Relevance to Clinical Practice. The 18 subthemes could be used as viewpoints to observe engagements of activity in clients with dementia. Limitations and Recommendations for Further Research. Future studies could examine which viewpoints were utilized for each type of activity and/or severity of dementia as this was not investigated in the current study.

scholarly journals Rehabilitation Therapists’ Clinical Questions in the Context of Evidence-Based Patient Care: An Exploratory Study

2013 ◽  
Author(s):  
Lorie Kloda ◽  
Joan Bartlett
Keyword(s):  
Qualitative Study ◽  
Patient Care ◽  
Exploratory Study ◽  
Occupational Therapists ◽  
Stroke Care ◽  
Evidence Based ◽  
Speech Language Pathologists ◽  
Accident Vasculaire Cérébral ◽  
Clinical Questions ◽  
Etude Qualitative

In this qualitative study, rehabilitation therapists (occupational therapists, physiotherapists, and speech-language pathologists) working in stroke care will be asked about their clinical questions. The goals of the study are: to identify common characteristics of questions, to develop a typology of questions, and to uncover reasons why certain questions are pursued.Pour cette étude qualitative, des thérapeutes en réadaptation (ergothérapeutes, physiothérapeutes et orthophonistes) œuvrant auprès de patients ayant subi un accident vasculaire cérébral sont interrogés à propos de leurs questions cliniques. Cette étude vise à déterminer les caractéristiques communes des questions, à dresser une typologie des questions et à découvrir les raisons pour lesquelles certaines questions adressées. 

Knowledge Translation and Evidence-Based Practice: A Qualitative Study on Clinical Dietitians’ Perceptions and Practices in Switzerland

2019 ◽  
Vol 119 (11) ◽  
pp. 1882-1889 ◽  
Author(s):  
Ludivine Soguel ◽  
Carla Vaucher ◽  
Theresa Bengough ◽  
Bernard Burnand ◽  
Sophie Desroches
Keyword(s):  
Qualitative Study ◽  
Knowledge Translation ◽  
Evidence Based Practice ◽  
Evidence Based

Implementing evidence-based practice: A context analysis to examine use of task-based approaches to upper-limb rehabilitation

2018 ◽  
Vol 81 (5) ◽  
pp. 285-289
Author(s):  
Mary Vining Radomski ◽  
Mattie Anheluk ◽  
Christine Arulanantham ◽  
Marsha Finkelstein ◽  
Nancy Flinn
Keyword(s):  
Upper Limb ◽  
Evidence Based Practice ◽  
Contextual Factors ◽  
Occupational Therapists ◽  
Evidence Based ◽  
Context Analysis ◽  
Upper Limb Rehabilitation ◽  
Context Specific ◽  
Limb Rehabilitation ◽  
Practice Implementation

Statement of context Many occupational therapists experience challenges in implementing evidence-based practice, which may be best approached as a context-specific enterprise. Critical reflection on practice This practice analysis article reports the results of analyzing 24 home programs that occupational therapists issued to rehabilitation inpatients with stroke upon their discharge home. Home programs did not reflect a task-based approach to upper-limb recovery, even though this is supported by established evidence. Examination of contextual factors provides a framework to facilitate evidence implementation. Implications for practice Occupational therapists may optimize evidence-based practice implementation by first evaluating and addressing practice-specific contextual factors.

Perception of Spanish primary healthcare nurses about evidence-based clinical practice: a qualitative study

2014 ◽  
Vol 61 (1) ◽  
pp. 90-98 ◽  
Author(s):  
J. Pericas-Beltran ◽  
S. Gonzalez-Torrente ◽  
J. De Pedro-Gomez ◽  
J.M. Morales-Asencio ◽  
M. Bennasar-Veny
Keyword(s):  
Clinical Practice ◽  
Qualitative Study ◽  
Primary Healthcare ◽  
Evidence Based
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