言语病理学家在中风临床实践指南方面的经验以及影响其使用的障碍和促进因素：一项全国性描述性研究。

Speech pathologists' experiences with stroke clinical practice guidelines and the barriers and facilitators influencing their use: a national descriptive study.

作者信息

Hadely Kathleen A, Power Emma, O'Halloran Robyn

机构信息

Discipline of Speech Pathology, Faculty of Health Sciences, The University of Sydney, 75 East Street, Lidcombe NSW 2141, Australia.

出版信息

BMC Health Serv Res. 2014 Mar 6;14:110. doi: 10.1186/1472-6963-14-110.

BACKGROUND

Communication and swallowing disorders are a common consequence of stroke. Clinical practice guidelines (CPGs) have been created to assist health professionals to put research evidence into clinical practice and can improve stroke care outcomes. However, CPGs are often not successfully implemented in clinical practice and research is needed to explore the factors that influence speech pathologists' implementation of stroke CPGs. This study aimed to describe speech pathologists' experiences and current use of guidelines, and to identify what factors influence speech pathologists' implementation of stroke CPGs.

METHODS

Speech pathologists working in stroke rehabilitation who had used a stroke CPG were invited to complete a 39-item online survey. Content analysis and descriptive and inferential statistics were used to analyse the data.

RESULTS

320 participants from all states and territories of Australia were surveyed. Almost all speech pathologists had used a stroke CPG and had found the guideline "somewhat useful" or "very useful". Factors that speech pathologists perceived influenced CPG implementation included the: (a) guideline itself, (b) work environment, (c) aspects related to the speech pathologist themselves, (d) patient characteristics, and (e) types of implementation strategies provided.

CONCLUSIONS

There are many different factors that can influence speech pathologists' implementation of CPGs. The factors that influenced the implementation of CPGs can be understood in terms of knowledge creation and implementation frameworks. Speech pathologists should continue to adapt the stroke CPG to their local work environment and evaluate their use. To enhance guideline implementation, they may benefit from a combination of educational meetings and resources, outreach visits, support from senior colleagues, and audit and feedback strategies.

背景

沟通和吞咽障碍是中风的常见后果。临床实践指南（CPG）已被制定出来，以帮助卫生专业人员将研究证据应用于临床实践，并可改善中风护理结果。然而，CPG在临床实践中往往未能成功实施，需要开展研究以探索影响言语病理学家实施中风CPG的因素。本研究旨在描述言语病理学家对指南的使用经验及现状，并确定哪些因素会影响言语病理学家对中风CPG的实施。