1 School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.
2 Department of Medicine, University of Toronto, Toronto, ON, Canada.
Clin Rehabil. 2018 Apr;32(4):546-556. doi: 10.1177/0269215517733114. Epub 2017 Sep 28.
To explore, from the perspective of healthcare providers, the barriers to and facilitators of using standardized outcome measures of physical function in geriatric rehabilitation settings.
In-depth semi-structured interviews with medical doctors, nurses, physiotherapists and occupational therapists were conducted from three geriatric rehabilitation hospitals in Ontario. Qualitative content analysis through an inductive approach was used to identify barriers to and facilitators of outcome measurement in geriatric rehabilitation settings.
A total of 20 healthcare providers from different disciplines were interviewed. Barriers are standardized outcome measures that (1) cannot be used in isolation to inform clinical decision-making for older patients, (2) are difficult to complete and interpret in older complex patients, (3) may not be useful for all members of the clinical team and (4) are used for reasons unrelated to patient care. Facilitators are to (1) divide the standardized outcome measure into components that are useful for each team member's practice, (2) encourage standardized outcome measures as tools for improving daily communication and (3) provide adequate education and support for their daily use.
This study revealed important barriers to using standardized outcome measures in geriatric rehabilitation from the perspective of healthcare providers. However, it also identified multiple factors that may help facilitate their use.
从医疗保健提供者的角度探讨在老年康复环境中使用物理功能标准化结果测量的障碍因素和促进因素。
在安大略省的三家老年康复医院对医生、护士、物理治疗师和职业治疗师进行了深入的半结构化访谈。采用归纳法的定性内容分析来确定老年康复环境中结果测量的障碍因素和促进因素。
共采访了来自不同学科的 20 名医疗保健提供者。障碍因素是标准化结果测量,(1)不能单独用于为老年患者提供临床决策,(2)在复杂的老年患者中完成和解释较为困难,(3)可能对临床团队的所有成员都没有用,(4)使用的原因与患者护理无关。促进因素是将标准化结果测量分为对每个团队成员实践有用的部分,(2)鼓励将标准化结果测量作为改善日常沟通的工具,(3)为日常使用提供足够的教育和支持。
本研究从医疗保健提供者的角度揭示了在老年康复中使用标准化结果测量的重要障碍因素,但也确定了多个可能有助于促进其使用的因素。