Auld Megan Louise, Johnston Leanne Marie
a Division of Physiotherapy, School of Health and Rehabilitation Sciences , The University of Queensland , Brisbane , Australia.
b Cerebral Palsy League , Brisbane , Australia.
Disabil Rehabil. 2018 Feb;40(3):267-276. doi: 10.1080/09638288.2016.1250170. Epub 2016 Nov 20.
Tactile impairments affect over 77% of children with unilateral cerebral palsy (CP). This study aimed to examine the current practices of pediatric therapists in relation to tactile assessment and the barriers to carrying out tactile assessment in children with CP.
The study was in two parts. In part one, pediatric therapists (n = 35) completed a questionnaire detailing their current knowledge and the use of tactile assessments in children. In part two, therapists (n = 12) completed a questionnaire based on the Theoretical Domains Framework examining the barriers and facilitators to completing tactile assessments in clinical practice.
Most therapists (over 90%) carry out tactile assessments in the minority (less than 25%) of children with CP that they treat. Therapists reported the need for improved knowledge/skills (n = 24) and confidence (n = 19) in carrying out tactile assessments, alongside the provision of necessary equipment (n = 17). Qualitative reports also suggested that organizational assessment guidelines and templates may facilitate the implementation of tactile assessment.
A multi-faceted knowledge translation strategy to address the barriers to tactile assessment among pediatric therapists needs to be developed. Implications for rehabilitation Pediatric occupational therapists and physiotherapists may not be completing tactile assessments according to current evidence-based recommendations. Therapists identified five main barriers, including a lack of knowledge, skills, belief in their capabilities (confidence), behavioral regulation (organizational procedures), and environmental context (e.g., equipment). Therapists recommended several potential facilitators, including access to necessary equipment, procedures, record sheets, training in tactile assessments, and research supporting related interventions. Service providers are encouraged to develop multi-faceted knowledge translation strategies that address these barriers and maximize facilitators.
触觉障碍影响超过77%的单侧脑瘫（CP）儿童。本研究旨在调查儿科治疗师在触觉评估方面的当前做法以及对CP儿童进行触觉评估的障碍。
该研究分为两个部分。在第一部分中，儿科治疗师（n = 35）完成了一份问卷，详细说明了他们目前在儿童触觉评估方面的知识和应用情况。在第二部分中，治疗师（n = 12）基于理论领域框架完成了一份问卷，调查了临床实践中完成触觉评估的障碍和促进因素。
大多数治疗师（超过90%）在他们治疗的少数（不到25%）CP儿童中进行触觉评估。治疗师报告称，在进行触觉评估时需要提高知识/技能（n = 24）和信心（n = 19），同时需要提供必要的设备（n = 17）。定性报告还表明，组织评估指南和模板可能有助于触觉评估的实施。
需要制定多方面的知识转化策略，以解决儿科治疗师在触觉评估方面的障碍。对康复的启示儿科职业治疗师和物理治疗师可能未按照当前基于证据的建议完成触觉评估。治疗师确定了五个主要障碍，包括知识不足、技能欠缺、对自身能力的信心不足、行为规范（组织程序）以及环境因素（如设备）。治疗师推荐了几个潜在的促进因素，包括获得必要的设备、程序、记录表、触觉评估培训以及支持相关干预措施的研究。鼓励服务提供者制定多方面的知识转化策略，以克服这些障碍并最大限度地发挥促进因素的作用。
