Barriers and facilitators to outcome measurement and treatment practices in aphasia rehabilitation in the USA: a mixed methods approach using the Theoretical Domains Framework.
Purpose: To identify clinician-perceived barriers and facilitators to the delivery of outcome measurement and evidence-based treatment practices and integration of these practices in aphasia rehabilitation. Materials and methods: Using a convergent mixed methods design, aphasia clinicians (n = 87) a...
| Publicado en: | Disability & Rehabilitation Vol. 46; no. 20; pp. 4695 - 4711 |
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| Autores principales: | , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Taylor & Francis Ltd
Oct2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=179941450&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 179941450 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09638288 B73 jtl: Disability & Rehabilitation issn: 09638288 maglogo: Y pubinfo: dt: Oct2024 vid: 46 iid: 20 pid: 377 pub: Taylor & Francis Ltd place: Philadelphia, Pennsylvania artinfo: ui: 179941450 179941450 179941450 10.1080/09638288.2023.2288221 179941450 ppf: 4695 ppct: 16 formats: tig: atl: Barriers and facilitators to outcome measurement and treatment practices in aphasia rehabilitation in the USA: a mixed methods approach using the Theoretical Domains Framework. aug: au: Tierney-Hendricks, Carla Schliep, Megan E. Vallila-Rohter, Sofia affil: Spaulding Rehabilitation Hospital, Boston, MA, USA sug: subj: Aphasia Rehabilitation Speech-Language Pathologists Psychosocial Factors Speech-Language Pathologist Attitudes Evaluation Decision Making, Clinical Treatment Outcomes Professional Practice, Evidence-Based Implementation Science Human United States Adult Middle Age Aged Aged, 80 and Over Conceptual Framework Multimethod Studies Descriptive Statistics Open-Ended Questionnaires Summated Rating Scaling Content Analysis Cross Sectional Studies Thematic Analysis Data Analysis Software Health Care Delivery, Integrated Professional Knowledge Memory Attention Intraprofessional Relations Professional-Client Relations Professional-Family Relations Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over ab: Purpose: To identify clinician-perceived barriers and facilitators to the delivery of outcome measurement and evidence-based treatment practices and integration of these practices in aphasia rehabilitation. Materials and methods: Using a convergent mixed methods design, aphasia clinicians (n = 87) across care settings in the United States completed an online survey designed within the Theoretical Domains Framework (TDF). Participants responded to open-ended questions and rated Likert scale statements. Qualitative data were analyzed using content analysis and quantitative data were summarized using descriptive statistics. Results: Factors related to the TDF domain of "environmental context and resources" (priority and productivity demands; characteristics of resources) were cited as primary barriers in 70% of qualitative responses for both outcome and treatment practices and were consistent with Likert rating statements. Facilitators were associated with TDF domains of "memory, attention, decision-making" (decision-making processes), "knowledge" (awareness of evidence) and "social influences" (client and caregiver preferences). Conclusions: Organizational-level factors and the misalignment of the research evidence with clinical needs are barriers to delivering evidence-based care in aphasia rehabilitation. Theoretically informed strategies such as establishing organizational infrastructure for practice change, developing clinically relevant evidence through research-practice partnerships, and implementing algorithms to support clinical decision-making can address barriers and leverage facilitators. IMPLICATIONS FOR REHABILITATION: Rehabilitation research needs to engage clinical partners and consider the healthcare context to provide the field with evidence-based outcome measures and treatment recommendations that meet the needs of the clinical environment. Clinical decision-making tools and algorithms have potential to support systematic, evidence informed care. Future implementation efforts need to test strategies that go beyond knowledge and skills training. Clinicians are optimistic for change in clinical practice within themselves and the profession. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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