Colquhoun Heather L, Islam Rafat, Sullivan Katrina J, Sandercock Jane, Steinwender Sandy, Grimshaw Jeremy M
Department of Occupational Science and Occupational Therapy, University of Toronto, 160-500 University Ave, Toronto, Ontario, M5G 1V7, Canada.
Ottawa Hospital Research Institute, Clinical Epidemiology Program, The Ottawa Hospital, General Campus, 501 Smyth Road, Centre for Practice Changing Research, Ottawa, Ontario, K1H 8L6, Canada.
Occup Ther Int. 2020 May 8;2020:3549835. doi: 10.1155/2020/3549835. eCollection 2020.
Occupational therapists have shown low adoption rates for many evidence-based practices. One such practice is the limited uptake of standardized outcome measures such as the Canadian Occupational Performance Measure. Use of this measure has not consistently translated into practice despite decades of encouragement. Theory-based approaches to understanding healthcare provider behaviour change are needed if we are to realize the goal of attaining practice that is in keeping with evidence. This study utilized the Theoretical Domains Framework, a theory-based approach for understanding barriers to evidence-based practice, in order to increase our understanding of the limited uptake of the Canadian Occupational Performance Measure in occupational therapy practice.
Theoretical Domains Framework methods were followed. First, primary data was collected from occupational therapists through semistructured interviews that focused on key behaviour change domains as they related to the use of the Canadian Occupational Performance Measure. Two independent researchers coded interview data into domains, derived belief statements from the data, and used belief strength, conflict, and frequency to determine the more and less influential domains for using the Canadian Occupational Performance Measure.
Interviews with 15 practicing occupational therapists across a range of practice areas yielded six key behaviour change domains for increasing the use of the Canadian Occupational Performance Measure. The more relevant domains were , , , , , and ). The other eight domains were found to be less relevant.
We identified important domains and beliefs that influence the use of the Canadian Occupational Performance Measure by occupational therapists. Results inform our understanding of the use of this measure in practice and identify potential targets for behaviour change interventions.
职业治疗师对许多循证实践的采用率较低。加拿大职业表现测量等标准化结局测量方法的采用率就很低。尽管经过数十年的推广，这种测量方法的使用仍未能始终如一地转化为实际应用。如果我们要实现使实践与证据相符的目标，就需要基于理论的方法来理解医疗保健提供者的行为改变。本研究采用了理论领域框架，这是一种基于理论的方法，用于理解循证实践的障碍，以增进我们对职业治疗实践中加拿大职业表现测量采用率低的理解。
遵循理论领域框架方法。首先，通过半结构化访谈从职业治疗师那里收集原始数据，访谈重点关注与加拿大职业表现测量使用相关的关键行为改变领域。两名独立研究人员将访谈数据编码到各个领域，从数据中得出信念陈述，并使用信念强度、冲突和频率来确定使用加拿大职业表现测量时影响力较大和较小的领域。
对来自一系列实践领域的15名执业职业治疗师进行的访谈得出了六个增加加拿大职业表现测量使用的关键行为改变领域。相关性较高的领域是 、 、 、 、 和 。发现其他八个领域相关性较低。
我们确定了影响职业治疗师使用加拿大职业表现测量的重要领域和信念。研究结果有助于我们理解该测量方法在实践中的使用情况，并确定行为改变干预的潜在目标。
