CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.
Implement Sci. 2010 Nov 23;5:92. doi: 10.1186/1748-5908-5-92.
The use of measurement tools is an essential part of good evidence-based practice; however, physiotherapists (PTs) are not always confident when selecting, administering, and interpreting these tools. The purpose of this study was to evaluate the impact of a multifaceted knowledge translation intervention, using PTs as knowledge brokers (KBs) to facilitate the use in clinical practice of four evidence-based measurement tools designed to evaluate and understand motor function in children with cerebral palsy (CP). The KB model evaluated in this study was designed to overcome many of the barriers to research transfer identified in the literature.
A mixed methods before-after study design was used to evaluate the impact of a six-month KB intervention by 25 KBs on 122 practicing PTs' self-reported knowledge and use of the measurement tools in 28 children's rehabilitation organizations in two regions of Canada. The model was that of PT KBs situated in clinical sites supported by a network of KBs and the research team through a broker to the KBs. Modest financial remuneration to the organizations for the KB time (two hours/week for six months), ongoing resource materials, and personal and intranet support was provided to the KBs. Survey data were collected by questionnaire prior to, immediately following the intervention (six months), and at 12 and 18 months. A mixed effects multinomial logistic regression was used to examine the impact of the intervention over time and by region. The impact of organizational factors was also explored.
PTs' self-reported knowledge of all four measurement tools increased significantly over the six-month intervention, and reported use of three of the four measurement tools also increased. Changes were sustained 12 months later. Organizational culture for research and supervisor expectations were significantly associated with uptake of only one of the four measurement tools.
KBs positively influenced PTs' self-reported knowledge and self-reported use of the targeted measurement tools. Further research is warranted to investigate whether this is a feasible, cost-effective model that could be used more broadly in a rehabilitation setting to facilitate the uptake of other measurement tools or evidence-based intervention approaches.
使用测量工具是循证实践的重要组成部分；然而，物理治疗师（PTs）在选择、管理和解释这些工具时并不总是自信。本研究的目的是评估一种多方面的知识转化干预措施的影响，该干预措施使用 PT 作为知识经纪人（KB），以促进在临床实践中使用四项针对脑瘫（CP）儿童运动功能评估和理解的循证测量工具。本研究评估的 KB 模型旨在克服文献中确定的许多研究转化障碍。
采用混合方法前后研究设计，评估了 25 名 KB 在加拿大两个地区的 28 个儿童康复机构中对 122 名实践 PT 进行为期六个月的 KB 干预对他们自我报告的知识和工具使用的影响。该模型是由位于临床地点的 PT KB 组成，由 KB 网络和研究团队的经纪人支持，通过经纪人支持 KB。为 KB 提供适度的财务报酬（六个月每周两小时）、持续的资源材料、个人和内部网支持。在干预前（六个月）、干预后立即（六个月）以及 12 个月和 18 个月收集调查问卷数据。采用混合效应多项逻辑回归分析来检验干预随时间和地区的影响。还探讨了组织因素的影响。
PTs 对所有四项测量工具的自我报告知识在六个月的干预中显著增加，对四项测量工具中的三项的自我报告使用也增加。变化在 12 个月后仍然持续。研究和主管期望的组织文化与仅对四项测量工具中的一项的采用显著相关。
KB 积极影响了 PTs 对目标测量工具的自我报告知识和自我报告使用。需要进一步研究，以调查这是否是一种可行且具有成本效益的模式，是否可以更广泛地用于康复环境中，以促进其他测量工具或循证干预方法的采用。
