A theory-based multi-component intervention to increase reactive balance measurement by physiotherapists in three rehabilitation hospitals: an uncontrolled single group study

BMC Health Services Research

Kathryn M. Sibley¹  Paula Gardner²  Paula Shing³  Jennifer Shaffer³  Sharon E. Straus⁴  Marla K. Beauchamp⁵  Sara McEwen⁶  Saima Hossain⁷  Susan B. Jaglal⁷  Mandy McGlynn⁷  Danielle C. Bentley⁷  Nancy M. Salbach⁷  Sachi O’Hoski⁸ 

[1] Department of Community Health Sciences, University of Manitoba;Department of Health Sciences, Brock University;Department of Physical Therapy, University of Toronto;Li Ka Shing Knowledge Institute – St. Michael’s Hospital;School of Rehabilitation Science, McMaster University;Sunnybrook Health Sciences Centre – St. John’s Rehab;Toronto Rehabilitation Institute- University Health Network;West Park Healthcare Centre;

关键词: Falls prevention;    Postural balance;    Evidence based practice;    Implementation science;    Health research;   

DOI  :  10.1186/s12913-018-3533-8

来源: DOAJ

【 摘 要 】

Abstract Background Most implementation interventions in rehabilitation, including physiotherapy, have used passive, non-theoretical approaches without demonstrated effectiveness. The goal of this study was to improve an important domain of physiotherapy practice – reactive balance measurement – with a targeted theory-based multi-component intervention developed using the Theoretical Domains Framework. The primary objective was to determine documented reactive balance measure use in a 12-month baseline, during, and for three months post- intervention. Methods An uncontrolled before-and-after study was completed with physiotherapists at three urban adult rehabilitation hospitals in Ontario, Canada. The 12-month intervention included group meetings, local champions, and health record modifications for a validated reactive balance measure. The primary outcome was the proportion of records with a documented reactive balance measure when balance was assessed pre-, during- and post-intervention. Secondary outcomes were changes in use, knowledge, and confidence post-intervention, differences across sites, and intervention satisfaction. Results Reactive balance was not measured in any of 211 eligible pre-intervention records. Thirty-three physiotherapists enrolled and 28 completed the study. Reactive balance was measured in 31% of 300 eligible records during-intervention, and in 19% of 90 eligible records post-intervention (p < 0.04). Knowledge and confidence significantly increased post-intervention (all p < 0.05). There were significant site differences in use during- and post-intervention (all p < 0.05). Most participants reported satisfaction with intervention content (71%) and delivery (68%). Conclusions Reactive balance measurement was greater among participants during-intervention relative to the baseline, and use was partially sustained post-intervention. Continued study of intervention influences on clinical reasoning and exploration of site differences is warranted.

【 授权许可】

Unknown