Improving rehabilitation treatment in a local setting: a case study of prosthetic rehabilitation.

OBJECTIVE: To contribute to the discussion on the research-practice gap by illustrating obstacles and opportunities that arise in an evidence-informed improvement process of prosthetic rehabilitation in a local setting. SETTING: Dutch rehabilitation centre. PRESUPPOSITION: The improvement process wa...

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Published in:Clinical Rehabilitation Vol. 23; no. 10; pp. 938 - 948
Main Authors: van Twillert S, Postema K, Geertzen JHB, Hemminga T, Lettinga AT
Format: case study pictorial research Journal Article
Published: Sage Publications Inc. Oct2009
Online Access:View this record in EBSCOhost
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      dt: Oct2009
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        atl: Improving rehabilitation treatment in a local setting: a case study of prosthetic rehabilitation.
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        au:
          van Twillert S
          Postema K
          Geertzen JHB
          Hemminga T
          Lettinga AT
        affil: Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Haren, The Netherlands; S.van.Twillert@cvr.umcg.nl
      sug:
        subj:
          Amputation Rehabilitation
          Attitude of Health Personnel Evaluation
          Quality Improvement Methods
          Rehabilitation Patients
          Action Research
          Age Factors
          Aged
          Data Analysis Software
          Focus Groups
          Functional Status
          Funding Source
          Interviews
          Limb Prosthesis
          Multidisciplinary Care Team
          Netherlands
          Nurses
          Occupational Therapists
          Patient Education
          Physical Therapists
          Professional-Patient Relations
          Psychiatrists
          Psychologists
          Quality of Health Care
          Research Personnel
          Semi-Structured Interview
          Social Workers
          Human
          Aged: 65+ years
      ab: OBJECTIVE: To contribute to the discussion on the research-practice gap by illustrating obstacles and opportunities that arise in an evidence-informed improvement process of prosthetic rehabilitation in a local setting. SETTING: Dutch rehabilitation centre. PRESUPPOSITION: The improvement process was considered as a two-way translation process rather than a unidirectional process of knowledge transfer between science and practice. METHOD: Case study and participatory research methods comprising documentary analysis, treatment observations, individual and focus groups interviews, and literature studies. A qualitative software program (Atlas-ti) was used to triangulate the collected data. RESULTS: The main concern of local practitioners was identified to be the post-discharge decline in functional capacity in elderly amputees. This was related to a predominantly biomedical and biomechanical approach, and accompanying traditional therapist-patient interactions. The content and underpinnings of prosthetic treatments were scarcely specified in either the scientific literature or the local setting. Generic principles and practices from other fields were useful for treatment innovation for post-discharge problems, such as task- and context-specific training and self-management education. A circuit training focused on motor learning and a problem-solving training focused on social learning were developed by integrating amputation-specific knowledge. CONCLUSION: Improving rehabilitation practice with the use of available evidence is a heterogeneous and multifaceted scientific enterprise. Such an enterprise requires as much self-reflexivity from researchers as from practitioners.
      pubtype: Academic Journal
      doctype:
        case study
        pictorial
        research
        Journal Article
      ougenre: Article
    language: English
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