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澳大利亚实施量身定制活动计划的障碍和促进因素:职业治疗师及其管理者的观点。

Barriers and enablers to the delivery and implementation of the tailored activity programme in Australia: Perspectives of occupational therapists and their managers.

机构信息

School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia.

School of Information Technology and Electrical Engineering, The University of Queensland, St Lucia, Queensland, Australia.

出版信息

Aust Occup Ther J. 2023 Apr;70(2):218-232. doi: 10.1111/1440-1630.12850. Epub 2022 Nov 17.

Abstract

BACKGROUND

Prior to implementing new programmes or practices, it is essential to understand the context, barriers and enablers to support successful use. The tailored activity programme (TAP) is an evidence-based intervention provided by occupational therapists to support community-dwelling people living with dementia and their carers. The programme was developed in the United States, and although it is not currently available for routine use in Australia, its implementation would address the needs of many Australians with dementia and their carers.

AIM

The aim of the study is to understand the perspectives of occupational therapists and their managers regarding barriers and enablers to the delivery and implementation of the TAP in Queensland, Australia.

METHODS

A qualitative descriptive methodology was employed. Semistructured interviews were undertaken with occupational therapists (n = 18) who work with community-dwelling people with dementia and their carers, and their managers (n = 10). Participants were recruited from a range of organisations across Queensland, and they were asked about potential barriers and enablers to implementing TAP. Interviews were recorded and transcribed verbatim. Data were mapped using framework analysis whilst remaining open to other themes.

FINDINGS

Themes were identified, and facilitating factors included the close alignment of TAP with occupational therapists' scope of practice; their acceptance of, and optimism about the programme and its perceived benefits including improved client outcomes; and an opportunity for occupational therapists to further develop their skills. Managerial support and carers' readiness and willingness to participate were also identified as important factors for success, whereas barriers were cost to clients and the capacity of the occupational therapy workforce to provide TAP.

CONCLUSION

Occupational therapists and their managers expressed enthusiasm for TAP and awareness of its likely benefits, while also identifying barriers that will need to be addressed if implementation of the programme is to be successful in Australia.

摘要

背景

在实施新的项目或实践之前,了解支持成功应用的背景、障碍和促进因素至关重要。定制活动计划(TAP)是一种基于证据的干预措施,由职业治疗师提供,以支持居住在社区中的痴呆症患者及其照顾者。该计划在美国开发,尽管目前在澳大利亚尚未常规使用,但实施该计划将满足许多澳大利亚痴呆症患者及其照顾者的需求。

目的

本研究旨在了解澳大利亚昆士兰州的职业治疗师及其管理者对 TAP 的提供和实施的障碍和促进因素的看法。

方法

采用定性描述性方法。对与居住在社区中的痴呆症患者及其照顾者一起工作的职业治疗师(n=18)及其管理者(n=10)进行半结构化访谈。参与者从昆士兰州的各种组织中招募,并询问他们在实施 TAP 方面的潜在障碍和促进因素。访谈进行了录音并逐字记录。使用框架分析对数据进行映射,同时保持对其他主题的开放性。

结果

确定了主题,促进因素包括 TAP 与职业治疗师的实践范围密切一致;他们对该计划及其预期收益的接受和乐观,包括改善客户结果;以及职业治疗师进一步发展技能的机会。管理支持以及照顾者的准备和意愿参与也是成功的重要因素,而障碍是客户的成本和职业治疗师提供 TAP 的劳动力能力。

结论

职业治疗师及其管理者对 TAP 表示热情,并意识到其可能带来的好处,同时也确定了如果要在澳大利亚成功实施该计划,将需要解决的障碍。

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