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Tailored GuideLine Implementation in STrokE Rehabilitation (GLISTER) in Germany. Protocol of a Mixed Methods Study
Bettina Scheffler1, Florian Schimböck2, Almut Schöler1
1Department of Therapy Sciences I, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany.
Frontiers in Neurology
|August 15, 2022
Summary
This study addresses the inconsistent use of evidence-based guidelines in stroke rehabilitation physical therapy. It aims to improve guideline adherence through a tailored intervention, enhancing patient outcomes and clinical decision-making.
Area of Science:
- Physical Therapy
- Rehabilitation Medicine
- Healthcare Implementation Science
Background:
- Evidence-based guidelines are crucial for optimizing clinical decision-making and patient outcomes in stroke rehabilitation.
- Inconsistent adoption of these guidelines by physical therapists highlights a significant theory-practice gap.
- The German guideline for evidence-based rehabilitation of mobility after stroke (ReMoS) serves as the focus for this implementation project.
Purpose of the Study:
- To characterize current physical therapy practices in German stroke rehabilitation.
- To identify barriers and facilitators influencing the utilization of the ReMoS guideline.
- To develop and pilot test a theory-informed, customized implementation intervention to promote guideline adherence.
Main Methods:
- A stepwise mixed-methods approach will be employed.
- Online questionnaires and a systematic mixed-methods review will assess current practices and quantitatively evaluate barriers/facilitators.
- Semi-structured interviews will provide qualitative insights, informing the development of an intervention based on the Behavior Change Wheel and Theoretical Domains Framework, followed by a controlled pilot test.
Main Results:
- This research will provide the first comprehensive analysis of current physical therapy practices in German stroke rehabilitation.
- It will identify specific barriers and facilitators to the implementation of the ReMoS guideline.
- The study will yield data on the effectiveness and feasibility of a tailored, theory-based implementation intervention.
Conclusions:
- This project pioneers the implementation of a guideline in German stroke rehabilitation by focusing on behavior change.
- It utilizes a tailored, theory-based approach informed by current practice and identified influencing factors.
- The study aims to bridge the theory-practice gap and ultimately improve stroke patient care through enhanced guideline utilization.
