Imms Christine, Kerr Claire, Bowe Steven J, Karlsson Petra, Novak Iona, Shields Nora, Reddihough Dinah
Centre for Disability and Development Research, Australian Catholic University, Fitzroy, Australia.
School of Nursing and Midwifery, Queen's University Belfast, Medical Biology Centre, Belfast, Northern Ireland, UK.
Disabil Rehabil. 2021 Dec;43(25):3592-3605. doi: 10.1080/09638288.2020.1727576. Epub 2020 Mar 5.
To investigate the effect of a knowledge translation intervention on knowledge and frequency of routine evidence-based assessment behaviours of healthcare professionals working with children with cerebral palsy.
A before-and-after longitudinal study was conducted in five disability organisations. Four organisations (Commencing Knowledge Translation group) implemented a multifaceted intervention: knowledge brokers, targeted education, electronic-evidence library, and clinical outcomes database. These strategies were already in place at the fifth organisation (Comparison group). Outcomes evaluated at 0, 6, 12, and 24 months were health-professional knowledge and routine assessment behaviours (self-report and "completeness" of clinical assessment). Generalised estimating equations determined longitudinal changes.
Four hundred and forty-seven professionals involved 861 children in the study. The Comparison group had higher knowledge and routine assessment behaviours at baseline. Professional knowledge in both groups remained stable (differences in change from baseline to 24 months: 0.3 units, 95%CI: -0.76 to 1.36). Assessment completeness of the Comparison group was stable (baseline mean 68 units, 95%CI: 65-71); the Commencing Knowledge Translation group improved from baseline mean 35 units (95%CI: 33-36), peaking at 12 months (mean 68 (95%CI: 65-71).
Multifaceted organisational support improved health-professional routine evidence-based assessment behaviours with children with cerebral palsy, despite no change in knowledge.
This trial was not a controlled health care intervention and was registered retrospectively: ACTRN12616001616460. The protocol of the trial was published in 2015 as follows: Imms et al. [6].Implications for rehabilitationA multifaceted knowledge translation intervention increased allied health professionals' assessment behaviours.Knowledge translation strategies can be chosen to target change in knowledge and/or change in behaviour.Knowledge translation interventions should be designed to address organisational barriers and enhance organisational supports.Interventions that target healthcare professionals' behaviour directly can be effective even if their knowledge does not change.
探讨知识转化干预对从事脑瘫患儿护理工作的医护人员的知识水平及常规循证评估行为频率的影响。
在五个残疾组织中开展了一项前后对照的纵向研究。四个组织（开始知识转化组）实施了多方面干预措施：知识中介、针对性教育、电子证据库和临床结果数据库。第五个组织（对照组）已具备这些策略。在0、6、12和24个月时评估的结果为医护人员的知识水平和常规评估行为（自我报告和临床评估的“完整性”）。广义估计方程确定纵向变化。
447名专业人员参与了该研究，涉及861名儿童。对照组在基线时具有更高的知识水平和常规评估行为。两组的专业知识均保持稳定（从基线到24个月的变化差异：0.3个单位，95%置信区间：-0.76至1.36）。对照组的评估完整性保持稳定（基线均值68个单位，95%置信区间：65 - 71）；开始知识转化组从基线均值35个单位（95%置信区间：33 - 36）有所改善，在12个月时达到峰值（均值68（95%置信区间：65 - 71）。
尽管知识水平没有变化，但多方面的组织支持改善了医护人员对脑瘫患儿的常规循证评估行为。
本试验并非对照医疗保健干预，进行了回顾性注册：ACTRN12616001616460。该试验方案于2015年发表如下：Imms等人[6]。对康复的启示多方面的知识转化干预增加了专职医疗人员的评估行为。可以选择知识转化策略来针对知识变化和/或行为变化。知识转化干预应设计用于解决组织障碍并加强组织支持。即使医护人员的知识没有改变，直接针对其行为的干预也可能有效。
