Singh Hardeep, Collins Kyla, Flett Heather M, Jaglal Susan B, Musselman Kristin E
KITE, Toronto Rehab-University Health Network, Toronto, Canada.
Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.
Disabil Rehabil. 2022 Aug;44(16):4351-4360. doi: 10.1080/09638288.2021.1904013. Epub 2021 Mar 31.
Therapists play a key role in delivering fall prevention/management education to individuals with spinal cord injury/disease, yet their perspectives on this topic remain understudied. Here, we described the perspectives of physical and occupational therapists who routinely provided rehabilitation to patients with spinal cord injury/disease on: (1) how fall risk was assessed, (2) what fall prevention education, interventions or strategies were provided, and (3) opportunities to improve fall risk assessment and the delivery of fall prevention education, strategies and interventions.
Twenty-one therapists completed an individual interview or focus group that was analyzed using an inductive thematic analysis.
Four main themes were identified: (1) policy and procedures impact practice (i.e., policy and procedures positively and negatively impact practice), (2) assessing and managing fall risk/falls in patients with spinal cord injury/disease (i.e., discipline-specific roles in fall risk assessments and fall management processes in rehabilitation), (3) fall prevention and management education (i.e., helicopter therapists and challenges with fall prevention and management education), (4) building insight into fall risk and management (e.g., building insight into fall risk for patients and therapists).
This study revealed opportunities to improve the delivery of fall prevention education and training to individuals with spinal cord injury/disease.IMPLICATIONS FOR REHABILITATIONFall prevention education should be initiated in spinal cord injury rehabilitation and then reinforced in community rehabilitation.Barriers and challenges faced by therapists when delivering fall prevention and management education/training in spinal cord injury rehabilitation include their perceptions of a patient's readiness to receive fall prevention education, short length of stay in rehabilitation, organization's expectations of zero falls and a lack of spinal cord injury-specific fall prevention resources.Therapists who work in spinal cord injury rehabilitation may benefit from information about fall risk factors encountered by individuals with spinal cord injury/disease in the community.
治疗师在为脊髓损伤/疾病患者提供预防跌倒/管理教育方面发挥着关键作用，然而他们对这一主题的看法仍未得到充分研究。在此，我们描述了经常为脊髓损伤/疾病患者提供康复治疗的物理治疗师和职业治疗师的看法，内容涉及：（1）如何评估跌倒风险；（2）提供了哪些预防跌倒教育、干预措施或策略；（3）改善跌倒风险评估以及预防跌倒教育、策略和干预措施实施的机会。
21名治疗师完成了个人访谈或焦点小组访谈，并采用归纳主题分析法进行分析。
确定了四个主要主题：（1）政策和程序影响实践（即政策和程序对实践有积极和消极影响）；（2）评估和管理脊髓损伤/疾病患者的跌倒风险/跌倒情况（即康复中跌倒风险评估和跌倒管理过程中的特定学科角色）；（3）预防跌倒和管理教育（即“直升机式”治疗师以及预防跌倒和管理教育面临的挑战）；（4）深入了解跌倒风险和管理（例如，深入了解患者和治疗师的跌倒风险）。
本研究揭示了改善向脊髓损伤/疾病患者提供预防跌倒教育和培训的机会。
对康复的启示
预防跌倒教育应在脊髓损伤康复中启动，然后在社区康复中强化。
治疗师在脊髓损伤康复中提供预防跌倒和管理教育/培训时面临的障碍和挑战包括他们对患者接受预防跌倒教育准备程度的看法、康复住院时间短、机构对零跌倒的期望以及缺乏针对脊髓损伤的预防跌倒资源。
在脊髓损伤康复领域工作的治疗师可能会从有关脊髓损伤/疾病患者在社区中遇到的跌倒风险因素的信息中受益。
