Do clinical guidelines guide clinical practice in stroke rehabilitation? An international survey of health professionals.

To identify health professionals awareness of stroke rehabilitation guidelines, and factors perceived to influence guideline use internationally. Online survey study. Open-ended responses were thematically analysed, guided by the Consolidated Framework for Implementation Research. Data from 833 resp...

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Published in:Disability & Rehabilitation Vol. 44; no. 15; pp. 4118 - 4126
Main Authors: Lynch, Elizabeth A., Connell, Louise A., Carvalho, Lilian B., Bird, Marie-Louise
Format: research tables/charts Journal Article
Published: Taylor & Francis Ltd Jul2022
Online Access:View this record in EBSCOhost
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      dt: Jul2022
      vid: 44
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      pub: Taylor & Francis Ltd
      place: Philadelphia, Pennsylvania
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        10.1080/09638288.2021.1891304
        158339148
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        atl: Do clinical guidelines guide clinical practice in stroke rehabilitation? An international survey of health professionals.
      aug:
        au:
          Lynch, Elizabeth A.
          Connell, Louise A.
          Carvalho, Lilian B.
          Bird, Marie-Louise
        affil: College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia
      sug:
        subj:
          Stroke Rehabilitation
          Attitude of Health Personnel
          Practice Patterns
          Practice Guidelines
          Human
          Surveys
          Treatment Outcomes
          Thematic Analysis
          Implementation Science
          Low and Middle Income Countries
          Audit
          Medical Practice, Evidence-Based
          Public Health
          Funding Source
      ab: To identify health professionals awareness of stroke rehabilitation guidelines, and factors perceived to influence guideline use internationally. Online survey study. Open-ended responses were thematically analysed, guided by the Consolidated Framework for Implementation Research. Data from 833 respondents from 30 countries were included. Locally developed guidelines were available in 22 countries represented in the sample. Respondents from high-income countries were more aware of local guidelines compared with respondents from low- and middle-income countries. Local contextual factors such as management support and a culture of valuing evidence-based practice were reported to positively influence guideline use, whereas inadequate time and shortages of skilled staff inhibited the delivery of guideline-recommended care. Processes reported to improve guideline use included education, training, formation of workgroups, and audit-feedback cycles. Broader contextual factors included accountability (or lack thereof) of health professionals to deliver rehabilitation consistent with guideline recommendations. While many health professionals were aware of clinical guidelines, they identified multiple barriers to their implementation. Efforts should be made to raise awareness of local guidelines in low- and middle-income countries. More attention should be paid to addressing local contextual factors to improve guideline use internationally, going beyond traditional strategies focused on individual health professionals. Systems are required so people and organisations are held accountable to deliver evidence-based care in stroke rehabilitation. Locally developed stroke rehabilitation guidelines should be promoted to boost awareness of these guidelines in low- and middle-income countries. In all regions, strategies to influence or adapt to the local setting, are required to optimise guideline use.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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