Camp Pat G, Benari Ori, Dechman Gail, Kirkham Ashley, Campbell Kristin, Black Agnes, Chung Frank, Dajee Preeya, Ellis Amy, Hoens Alison M, Jones Rosalyn, Parappilly Beena, Singh Chiara, Sweeney Philip, Woo Ellen
Department of Physical Therapy and.
Centre for Heart Lung Innovation, University of British Columbia, Vancouver, British Columbia, Canada.
ATS Sch. 2021 May 4;2(2):249-264. doi: 10.34197/ats-scholar.2020-0129OC. eCollection 2021 Jun.
Improving the mobility of hospitalized patients with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a priority of care. AECOPD-Mob is a clinical decision-making tool for physical therapists, especially those who are newly graduated or are new to caring for patients with AECOPDs in acute care settings. Although this tool has been available for several years, dissemination via publication is not sufficient to implement it in clinical practice. The primary objective of this study was to develop, implement, and evaluate different formats of AECOPD-Mob in an acute care setting. We used a mixed-methods, convergent parallel design. In addition to the paper format of AECOPD-Mob, we developed a smartphone app, a web-based learner module, and an in-service learning session. Newly graduated physical therapists (PTs) or PTs new to the practice area were recruited from urban acute care hospitals. Participants used the different formats for 3 weeks and then completed the Post-Study System Usability Questionnaire. User data were retrieved for the learning module. Participants participated in focus groups at 3 weeks and 3 months. Eighteen (72% of eligible PTs, 100% female, 94% graduated within 3 yr) PTs participated. Post-Study System Usability Questionnaire scores for the learning module and smartphone indicated that participants were satisfied with these formats (median score 2.0 on 1-7 Likert Scale for both technology formats, lower scores indicating greater satisfaction). However, the participants reported in the focus group that the paper format was preferred over other formats. Concerns with the smartphone app included infection control and the perception of lack of professionalism when using a smartphone during clinical practice. The learning module and in-service were considered helpful as an introduction but not as an ongoing support. The paper format was seen as the most efficient way to access the necessary information and to facilitate communication between other members of the care team about the importance of mobility for hospitalized patients with AECOPDs. Newly graduated PTs strongly preferred the paper format of the AECOPD-Mob tool in the acute care setting. Future research will focus on knowledge translation strategies for other health disciplines.
提高慢性阻塞性肺疾病急性加重期（AECOPD）住院患者的活动能力是护理的重点。AECOPD - Mob是一种供物理治疗师使用的临床决策工具，尤其适用于刚毕业或在急性护理环境中初次护理AECOPD患者的治疗师。尽管该工具已问世数年，但仅通过出版物传播不足以在临床实践中实施。本研究的主要目的是在急性护理环境中开发、实施和评估不同形式的AECOPD - Mob。我们采用了混合方法、收敛平行设计。除了AECOPD - Mob的纸质形式，我们还开发了一款智能手机应用程序、一个基于网络的学习模块和一次在职学习课程。从城市急性护理医院招募刚毕业的物理治疗师（PT）或该实践领域的新手PT。参与者使用不同形式的工具3周，然后完成研究后系统可用性问卷。获取了学习模块的用户数据。参与者在3周和3个月时参加焦点小组。18名PT（占符合条件PT的72%，均为女性，94%在3年内毕业）参与了研究。学习模块和智能手机的研究后系统可用性问卷得分表明参与者对这些形式感到满意（两种技术形式在1 - 7李克特量表上的中位数得分均为2.0，得分越低表示满意度越高）。然而，参与者在焦点小组中表示，比起其他形式，他们更喜欢纸质形式。对智能手机应用程序的担忧包括感染控制以及在临床实践中使用智能手机时缺乏专业感。学习模块和在职培训被认为作为入门很有帮助，但不能提供持续支持。纸质形式被视为获取必要信息以及促进护理团队其他成员就AECOPD住院患者活动能力的重要性进行沟通的最有效方式。在急性护理环境中，刚毕业的PT强烈偏爱AECOPD - Mob工具的纸质形式。未来的研究将聚焦于其他健康学科的知识转化策略。
