School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Canada Royal Victoria Hospital, McGill University Health Center, Montreal, Canada.
School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Canada Centre de recherche interdisciplinaire en réadaptation du Montréal Métropolitain, Montreal, Canada.
Top Stroke Rehabil. 2014 May-Jun;21(3):228-36. doi: 10.1310/tsr2103-228.
A gap exists between best and actual management of poststroke unilateral spatial neglect (USN). Given the negative impact of USN on poststroke recovery, knowledge translation efforts are needed to optimize USN management. To date, no study has investigated the specific barriers and facilitators affecting USN management during the acute care process.
To identify the facilitators and barriers that affect evidence-based practice use by occupational therapists (the primary discipline managing USN) when treating individuals with acute poststroke USN.
Focus group methodology elicited information from 9 acute care occupational therapists.
Key barriers identified included lack of basic evidence-based practice skills specific to USN treatment and personal motivation to change current practices and engrained habits. Key facilitators included the presence of a multidisciplinary stroke team, recent graduation, and an environment with access to learning time and resources. Synthesized Web-based learning was also seen as important to uptake of best practices.
It is estimated that upwards of 40% of patients experience poststroke USN in the acute phase, and we have evidence of poor early management. This study identified several modifiable factors that prepare the ground for the creation and testing of a multimodal knowledge translation intervention aimed at improving clinicians' best practice management of poststroke USN.
脑卒中后单侧空间忽略（USN）的最佳管理与实际管理之间存在差距。鉴于 USN 对脑卒中后恢复的负面影响，需要进行知识转化工作，以优化 USN 的管理。迄今为止，尚无研究调查影响急性护理过程中 USN 管理的具体障碍和促进因素。
确定影响职业治疗师（主要负责管理 USN 的学科）在治疗急性脑卒中后单侧空间忽略个体时采用基于证据的实践的促进因素和障碍。
采用焦点小组方法从 9 名急性护理职业治疗师处获取信息。
确定的主要障碍包括缺乏针对 USN 治疗的基本基于证据的实践技能以及改变当前实践和固有习惯的个人动机。主要促进因素包括多学科脑卒中团队的存在、最近毕业以及有学习时间和资源的环境。综合网络学习也被视为采用最佳实践的重要因素。
据估计，超过 40%的患者在急性阶段经历脑卒中后 USN，而我们有证据表明早期管理不善。本研究确定了一些可改变的因素，为创建和测试旨在改善临床医生对脑卒中后 USN 的最佳实践管理的多模式知识转化干预措施奠定了基础。
