了解临床实践中的行为变化 实施指南:一种定性研究
Julie K Tilson1, Clarisa Martinez, Sharon Mickan
1Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California (J.K.T., C.M., and R.H.); Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia (S.M.); Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center Kansas City, Missouri (L.J.D.); Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana (S.M.); Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois (H.R.R.); Physical Medicine and Rehabilitation Services, James A. Haley Veterans Hospital, Tampa, Florida and University of South Florida, Morsani College of Medicine, Tampa, Florida (K.M.S.); Jewish Rehabilitation Hospital, CISSS Laval, Laval, Quebec, Canada (E.D.); and Symmetry Alliance, Weston, Florida (L.F.).
改善对神经物理治疗临床实践指南 (CPG) 的遵守,需要支持团队,反和治疗师的学习机会. 通过个性化的教育和明确的进度指标,提高了患者的参与度.
科学领域:
- 神经学物理治疗 神经学物理治疗
- 基于证据的实践.
- 行为科学 行为科学
背景情况:
- 临床实践指南 (CPG) 越来越多地适用于神经物理治疗师.
- 坚持CPG通常需要治疗师和患者显著的行为改变.
- 了解这种行为变化的驱动因素对于有效实施至关重要.
研究的目的:
- 探索治疗师在坚持CPG方面的经验和观点.
- 为实施CPG的治疗师确定行为改变的关键驱动因素.
- 了解患者对CPG实施对其护理的影响的看法.
主要方法:
- 一项为期6个月的实施研究,使用5个地点的"知识转化为行动"模式.
- 在干预后,与治疗师和患者进行半结构化采访和焦点小组.
- 使用能力,机会,动机,行为 (COM-B) 模型进行诱导现象学分析和二次分析.
主要成果:
- 治疗师的主题包括反,团队合作,复杂性,领导力,参与和动机.
- 患者主题专注于沟通,个性化,支持和恢复.
- 该COM-B模型突出了治疗师和患者行为变化的特定驱动因素.
结论:
- 通过协作团队,审计反,学习和问责制来促进治疗师的坚持.
- 通过个性化的教育,客观的进步措施和强大的治疗联盟,提高了患者参与度.
- 成功的CPG实施依赖于解决提供者和患者行为因素.
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