Programme in Occupational Therapy, School of Medicine, Washington University, St. Louis, MO, USA.
Disabil Rehabil Assist Technol. 2023 Oct;18(7):1154-1162. doi: 10.1080/17483107.2021.1993359. Epub 2021 Oct 22.
The purpose of this study was to identify clinician knowledge regarding manual wheelchair (MWC) training in an inpatient rehabilitation (IPR) setting, identify current MWC education provided to new manual wheelchair users (MWUs), and determine how MWC training resources can be developed or modified to promote use among IPR clinicians.
Semi-structured interviews were conducted with 20 licenced IPR clinicians who work with MWUs. Using a traditional qualitative research design, researchers completed open, data-driven coding of interview transcripts. Overarching themes were determined through content analysis.
Participants included 12 physical therapists, six occupational therapists, one physical therapy assistant, and one occupational therapy assistant. Five themes emerged from the interviews: (1) clinician knowledge, education, and experience (2) current training content (3) training environment, (4) desired programme components (5) barriers to implementation. Participants reported receiving minimal education in school and from their employers on training MWUs. While clinicians expressed the importance of MWU education, they used varying training approaches with little standardization. Participants identified that training protocols for IPR are beneficial if they are quick, straightforward, and flexible.
While MWC training occurs during IPR stays, it appears to be inconsistent across facilities, clinicians, and patients, with varying degrees of adherence to evidence-based practices. This is likely due to limited feasibility and awareness of existing MWC training resources. Clinician input gathered from these interviews provides information for how to best integrate MWC training programmes into the rehabilitative process. Findings may inform the development and assessment of more clinically feasible MWC training protocols. Implications for RehabilitationNew manual wheelchair users must learn numerous wheelchair-related skills in order to participate in everyday life activities.Manual wheelchair education for new users during inpatient rehabilitation is often inconsistent across facilities, clinicians, and patients, with varying degrees of adherence to existing evidence-based practices.Systematic challenges often act as a barrier to the implementation of more comprehensive, structured manual wheelchair training protocols.Manual wheelchair training resources must be concise, flexible, customisable, and easy to follow in order to promote increased implementation among inpatient rehabilitation clinicians.
本研究旨在确定住院康复（IPR）环境中临床医生对手动轮椅（MWC）培训的了解，确定当前向新手动轮椅使用者（MWU）提供的 MWC 教育，并确定如何开发或修改 MWC 培训资源，以促进 IPR 临床医生的使用。
对 20 名从事 MWU 工作的持牌 IPR 临床医生进行了半结构式访谈。研究人员采用传统的定性研究设计，对手册转录本进行了开放式、数据驱动的编码。通过内容分析确定了总体主题。
参与者包括 12 名物理治疗师、6 名职业治疗师、1 名物理治疗助理和 1 名职业治疗助理。访谈中出现了五个主题：（1）临床医生的知识、教育和经验（2）当前的培训内容（3）培训环境（4）所需的方案组件（5）实施障碍。参与者报告在学校和雇主那里接受的 MWC 培训教育很少。尽管临床医生表示 MWC 教育很重要，但他们使用的培训方法各不相同，几乎没有标准化。参与者认为，如果 IPR 的培训方案快速、直接且灵活，那么培训方案是有益的。
虽然 MWC 培训发生在 IPR 期间，但它在设施、临床医生和患者之间似乎不一致，并且对循证实践的遵守程度也各不相同。这可能是由于对现有的 MWC 培训资源的可行性和认识有限。从这些访谈中收集的临床医生的意见提供了有关如何将 MWC 培训计划最佳整合到康复过程中的信息。调查结果可能会影响更具临床可行性的 MWC 培训方案的开发和评估。
新的手动轮椅使用者必须学习许多与轮椅相关的技能，以便参与日常生活活动。
在住院康复期间，新的手动轮椅使用者的教育在设施、临床医生和患者之间往往不一致，对现有的循证实践的遵守程度也各不相同。
系统挑战通常是实施更全面、结构化的手动轮椅培训方案的障碍。
手动轮椅培训资源必须简洁、灵活、可定制且易于遵循，以促进住院康复临床医生的更多实施。
