Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
College of Allied Medical Professions, The University of the Philippines, Manila, Philippines.
Disabil Rehabil. 2023 Jun;45(12):1947-1954. doi: 10.1080/09638288.2022.2080286. Epub 2022 Jun 2.
To explore health professionals' acceptance of the guidelines for acute whiplash associated disorders (WAD), and to identify barriers and facilitators to adherence.
Qualitative descriptive study involving focus group discussions among health professionals who treat people with WAD in primary and secondary care settings in New South Wales and Queensland, Australia. Twenty-eight health professionals (physiotherapists = 19; chiropractors = 6; osteopaths = 3) participated in six semi-structured focus group discussions that were held in independent offices in Sydney and Brisbane, Australia between September and December 2015. Discussions were audio recorded and verbatim, de-identified transcripts produced. Thematic analysis was conducted using an inductive approach to identify commonly held beliefs.
Acceptance of guideline recommendations appeared to be influenced by factors related to the guideline itself, practitioner and practice characteristics, and patient-related factors. Specifically, acceptance was hindered by conflicting belief systems, ambiguity in guideline recommendations, and patient characteristics and expectations.
Practitioners demonstrated a positive attitude towards the use of the guidelines in general; however, in some cases, acceptance of key recommendations appeared selective. Future guideline revision and implementation might focus on explaining the underlying principles of the guidelines, providing more detailed recommendations, and involving strategies that challenge inconsistent beliefs and promote informed decision-making. IMPLICATIONS FOR REHABILITATIONSelective acceptance of guideline recommendations in favour of those not requiring practice change may present a challenge for the implementation of evidence-based practice in the management of whiplash.Participants demonstrated variable, sometimes polar attitudes to guideline key messages and recommendations.Guideline developers need to focus more strongly on changing practitioner beliefs and attitudes, as well as better explaining the underlying principles of the guidelines, and providing more detailed recommendations.
探讨健康专业人员对急性颈扭伤相关疾病（WAD）指南的接受程度，并确定遵守这些指南的障碍和促进因素。
采用定性描述性研究，在澳大利亚新南威尔士州和昆士兰州的初级和二级保健环境中治疗 WAD 患者的卫生专业人员中进行焦点小组讨论。28 名卫生专业人员（物理治疗师=19 人；脊医=6 人；整骨医生=3 人）参加了 2015 年 9 月至 12 月在澳大利亚悉尼和布里斯班的独立办公室举行的 6 次半结构化焦点小组讨论。讨论内容进行了录音并逐字记录，生成了去识别身份的文字记录。采用归纳法进行主题分析，以确定共同持有的信念。
指南建议的接受程度似乎受到与指南本身、从业者和实践特征以及患者相关因素有关的因素的影响。具体而言，接受受到以下因素的阻碍：信念体系冲突、指南建议不明确以及患者特征和期望。
从业者对使用该指南的态度总体上是积极的；然而，在某些情况下，对关键建议的接受似乎是有选择性的。未来的指南修订和实施可能侧重于解释指南的基本原则，提供更详细的建议，并采取策略挑战不一致的信念，促进知情决策。
选择性地接受有利于不要求改变实践的指南建议，可能对在管理颈扭伤方面实施循证实践提出挑战。
参与者对指南关键信息和建议表现出不同的、有时是截然相反的态度。
指南制定者需要更加注重改变从业者的信念和态度，以及更好地解释指南的基本原则，并提供更详细的建议。
