Department of Applied Medicine and Rehabilitation, Indiana State University, Terre Haute, IN 47809, USA.
Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA.
Int J Environ Res Public Health. 2023 Mar 2;20(5):4440. doi: 10.3390/ijerph20054440.
In healthcare, disablement model frameworks aim to improve the delivery of patient-centered care through the recognition of patient factors beyond impairments, restrictions, and limitations, which include personal, environmental, and societal factors. Such benefits translate directly to athletic healthcare providing a mechanism for athletic trainers (ATs), as well as other healthcare professionals, to ensure that all aspects of the patient are managed prior to returning to work or sport. The purpose of this study was to investigate ATs recognition and use of disablement frameworks in current clinical practice. We used criterion sampling to identify ATs who were currently practicing from a random sample of ATs that participated in a related cross-sectional survey. A total of 13 participants engaged in an online, audio-only, semi-structured interview that was audio-recorded and transcribed verbatim. A consensual qualitative research (CQR) approach was used to analyze the data. A coding team of three individuals used a multi-phase process to construct a consensus codebook that identified common domains and categories among the participants' responses. Four domains emerged regarding ATs' experiences and recognition of disablement model frameworks. The first three domains were related to the application of disablement model frameworks: (1) patient-centered care, (2) limitations and impairments, and (3) environment and support. Participants described varying degrees of competence and consciousness regarding these domains. The fourth domain related to participants' exposure to disablement model frameworks through formal or informal experiences. Findings suggest that ATs largely demonstrate unconscious incompetence regarding the use of disablement frameworks in clinical practice.
在医疗保健领域，失能模型框架旨在通过识别患者的损伤、限制和功能障碍之外的因素，包括个人、环境和社会因素，来改善以患者为中心的护理服务。这些好处直接转化为运动医学保健，为运动训练师（AT）以及其他医疗保健专业人员提供了一种机制，以确保在患者重返工作或运动之前，管理好患者的各个方面。本研究旨在调查 AT 在当前临床实践中对失能框架的认识和使用。我们使用标准抽样法，从参与相关横断面调查的 AT 随机样本中确定目前正在执业的 AT。共有 13 名参与者参与了在线、仅音频、半结构化访谈，访谈内容被录音并逐字转录。我们采用共识定性研究（CQR）方法来分析数据。一个由三名成员组成的编码团队使用多阶段过程构建了一个共识代码本，该代码本确定了参与者回复中的常见领域和类别。关于 AT 对失能模型框架的经验和认识，有四个领域出现。前三个领域与失能模型框架的应用有关：（1）以患者为中心的护理，（2）限制和损伤，（3）环境和支持。参与者描述了在这些领域中不同程度的能力和意识。第四个领域与参与者通过正式或非正式经验接触失能模型框架有关。研究结果表明，AT 在临床实践中使用失能框架的能力主要表现为无意识的无能。
