Aspects affecting occupational therapists' reasoning when implementing research-based evidence in stroke rehabilitation

Kristensen, Hanne Kaae; Borg, Tove; Hounsgaard, Lise

doi:10.3109/11038128.2011.556197

Cited by 29 publications

(25 citation statements)

References 33 publications

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“…33,39 A core feature of the expert clinician is their ability to combine knowledge with experience, to know what is important, and to recognize and appreciate the significance of critical cues. 4,15,31,42,43 To date conceptual reasoning frameworks remain relatively general to the practice of therapy, 4,17,44 suggesting that research is needed to explore the clinical reasoning process of expert clinicians in specialty areas. 33,45,46 The purpose of this study is to gain a greater depth of understanding of the critical aspects of tacit knowledge informing and extending the cognitive processing used in the clinical reasoning of expert neuro-rehabilitation therapists, specifically, instructors from the International Bobath Instructors Training Association (IBITA).…”

Section: Clinical Reasoning and Knowledgementioning

confidence: 99%

“…Expert clinicians apply theory in a variety of ways to be able to make it useful to particular patients, in their specific situations, as well as generating new knowledge in the form of practice principles . A core feature of the expert clinician is their ability to combine knowledge with experience, to know what is important, and to recognize and appreciate the significance of critical cues …”

Section: Introductionmentioning

confidence: 99%

“…[9][10][11] The role of clinical reasoning in professional practice and its underpinning theory, the understanding of "why" a therapist chooses a particular intervention, including attention to technical expertise has been sadly lacking and largely ignored in the current rehabilitation sciences evidence base. [12][13][14][15][16][17][18] Evidence-based practice is concerned with generalizations and probabilities, ie, the probability of an intervention working for a described population, while eliminating bias. 19 Generalizable knowledge however is insufficient for professional practice as professional practice is concerned with particulars, the individual within a specific context.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Phronesis: practical wisdom the role of professional practice knowledge in the clinical reasoning of Bobath instructors

Vaughan-Graham

Cott

2016

Evaluation Clinical Practice

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Section: Clinical Reasoning and Knowledgementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Phronesis: practical wisdom the role of professional practice knowledge in the clinical reasoning of Bobath instructors

Vaughan-Graham

Cott

2016

Evaluation Clinical Practice

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“…[1][2][3][4] EBP involves the ethically sound application of research-based knowledge and includes the use of clinical practice guidelines (CPG) in clinical and organizational decision-making. In this study, leadership is conceptualized as "a multidimensional process of influence to enable staff members to use research evidence in clinical practice, and includes behaviors and activities of managers that exert direct or indirect influence on individuals, their environment, and organizational infrastructure" (p 128).…”

Section: Introductionmentioning

confidence: 99%

Developing Leadership in Managers to Facilitate the Implementation of National Guideline Recommendations: A Process Evaluation of Feasibility and Usefulness

Tistad

Palmcrantz

Wallin

et al. 2016

Int J Health Policy Manag

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Background: Previous research supports the claim that managers are vital players in the implementation of clinical practice guidelines (CPGs), yet little is known about interventions aiming to develop managers' leadership in facilitating implementation. In this pilot study, process evaluation was employed to study the feasibility and usefulness of a leadership intervention by exploring the intervention's potential to support managers in the implementation of national guideline recommendations for stroke care in outpatient rehabilitation. Methods: Eleven senior and frontline managers from five outpatient stroke rehabilitation centers participated in a fourmonth leadership intervention that included workshops, seminars, and teleconferences. The focus was on developing knowledge and skills to enhance the implementation of CPG recommendations, with a particular focus on leadership behaviors. Each dyad of managers was assigned to develop a leadership plan with specific goals and leadership behaviors for implementing three rehabilitation recommendations. Feasibility and usefulness were explored through observations and interviews with the managers and staff members prior to the intervention, and then one month and one year after the intervention. Results: Managers considered the intervention beneficial, particularly the participation of both senior and frontline managers and the focus on leadership knowledge and skills for implementing CPG recommendations. All the managers developed a leadership plan, but only two units identified goals specific to implementing the three stroke rehabilitation recommendations. Of these, only one identified leadership behaviors that support implementation. Conclusion: Managers found that the intervention was delivered in a feasible way and appreciated the focus on leadership to facilitate implementation. However, the intervention appeared to have limited impact on managers' behaviors or clinical practice at the units. • Pilot studies preceding larger implementation studies are useful to ensure both intervention and data collection feasibility. Implications for the publicTo this day, changes in healthcare are a major challenge; many of today's errors and adverse events could be prevented by using evidence-based practice (EBP). However, implementing EBP is easier said than done, and a complete picture as to what facilitates this process is yet to come. One aspect considered vital is the behavior of managers to facilitate guideline implementation. In this study, we piloted a leadership intervention based on a particular theoretical model to support managers in developing implementation plans. We found that the managers appreciated the model, and found it relevant to their practice. However, few implementation plans reflected their own role in facilitating the implementation of stroke rehabilitation guidelines. Further studies should provide supplementary support to managers, in order to facilitate their guideline implementation.

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“…In fact the concept of person-centered care includes personal views [10] . As an example clinical work has been seen to be influenced of personal views among Danish occupational therapists [28] .…”

Section: Discussionmentioning

confidence: 99%

Beliefs about medicines among prescribing and non-prescribing nurses in Sweden

Mårdby

Jakobsson

Hedenrud

2014

JNEP

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Background: The beliefs patients and health care providers have about medicines are important for communication about medicines, which is a central tool for patient-centered care and the quality of care. This study aimed to analyze general beliefs about medicines among prescribing and non-prescribing nurses. Methods:In this cross-sectional study a survey (Beliefs about Medicines Questionnaire, socio-demographic factors, years of professional experience and the right to prescribe) was sent to 303 nurses in Region Västra Götaland, Sweden, in 2007 (response rate: 80.5%). Analyses were made with independent t-tests, analyses of variance and linear regressions. Results:The beliefs about medicines among nurse prescribers did not differ from those of non-prescribing nurses. Professional experience was, however, important for harmful beliefs about medicines. Non-prescribing nurses with 16-30 years of professional experience had more harmful beliefs about medicines compared with non-prescribing nurses with less professional experience. Conclusions:It is important to further examine the possible effects of education and professional experience on beliefs among nurses. During the communication between nurses and patients there is a need for increased awareness of the importance of professional experience for beliefs about medicines.

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Aspects affecting occupational therapists' reasoning when implementing research-based evidence in stroke rehabilitation

Cited by 29 publications

References 33 publications

Phronesis: practical wisdom the role of professional practice knowledge in the clinical reasoning of Bobath instructors

Phronesis: practical wisdom the role of professional practice knowledge in the clinical reasoning of Bobath instructors

Developing Leadership in Managers to Facilitate the Implementation of National Guideline Recommendations: A Process Evaluation of Feasibility and Usefulness

Beliefs about medicines among prescribing and non-prescribing nurses in Sweden

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