Medical Biology Centre, School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland.
Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
Disabil Rehabil. 2023 Mar;45(6):1005-1015. doi: 10.1080/09638288.2022.2046874. Epub 2022 Mar 26.
To understand how healthcare professionals' perceptions of supports and barriers to routine clinical assessment, for children aged 3-18 years with cerebral palsy, evolved in the presence of a knowledge translation intervention.
A prospective longitudinal mixed-methods study was completed. The intervention comprised knowledge brokers, an e-evidence library, locally provided education and embedding routine clinical assessment in practice. Healthcare professionals from five disability services completed the Supports and Barriers Questionnaire and focus groups at baseline, 6, 12 and 24 months. Quantitative data were analysed descriptively and qualitative data using longitudinal framework analysis.
Questionnaire ratings indicated participants felt supported in implementing routine assessment over time. Subtle differences emerged from the longitudinal framework analysis. Participants shifted from 'adopting' to 'embedding' and 'maintaining' routine assessment. Integration of assessment was impacted by a new national disability funding model. Participants highlighted the need to maintain skills and for unambiguous, sustained communication between the organisation, clients, and stakeholders. If, how and why families engaged with routine assessment developed over time.
After an initial focus on pragmatic implementation issues, over time healthcare professionals began to reflect more on the complexities of children and families' engagement with assessment and the impact on the therapist-child-family relationship. This trial was not a controlled healthcare intervention and was registered retrospectively: ACTRN12616001616460. The protocol of the trial was published in 2015.IMPLICATIONS FOR REHABILITATIONHealthcare professionals can be supported over time to embed routine clinical assessment using multifaceted knowledge translation interventions.It takes time and ongoing support for healthcare professionals to embed, maintain and begin to adapt the routine clinical assessment to fit with policy, organisational context and the needs and wishes of children and families.Understanding and tailoring knowledge translation approaches to the policy context are essential.Even in the context of major policy shifts, it is possible to harness the commitment of organisations and professionals to improve their services in line with evidence-based approaches.
了解在知识转化干预措施存在的情况下，医疗保健专业人员对 3-18 岁脑瘫儿童常规临床评估的支持和障碍的看法是如何演变的。
完成了一项前瞻性纵向混合方法研究。该干预措施包括知识经纪人、电子证据库、本地提供的教育以及将常规临床评估嵌入实践中。来自五个残疾服务机构的医疗保健专业人员在基线、6、12 和 24 个月时完成了支持和障碍问卷和焦点小组。定量数据采用描述性分析，定性数据采用纵向框架分析。
问卷评分表明，参与者随着时间的推移，在实施常规评估方面感到得到了支持。纵向框架分析显示出细微的差异。参与者从“采用”转变为“嵌入”和“维持”常规评估。评估的整合受到新的国家残疾资金模式的影响。参与者强调需要保持技能，并在组织、客户和利益相关者之间进行明确、持续的沟通。家庭参与常规评估的方式、时间和原因随着时间的推移而发展。
在最初关注务实的实施问题之后，随着时间的推移，医疗保健专业人员开始更多地反思儿童和家庭对评估的参与的复杂性，以及对治疗师-儿童-家庭关系的影响。这项试验不是对照性的医疗保健干预措施，而是在回顾时进行注册的：ACTRN12616001616460。试验方案于 2015 年公布。
医疗保健专业人员可以通过多方面的知识转化干预措施，随着时间的推移得到支持，将常规临床评估嵌入实践中。医疗保健专业人员需要时间和持续的支持，才能将常规临床评估嵌入、维持并开始调整，以适应政策、组织背景以及儿童和家庭的需求和愿望。了解和调整知识转化方法以适应政策背景至关重要。即使在重大政策转变的背景下，也有可能利用组织和专业人员的承诺，根据循证方法来改善他们的服务。
