Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Quebec, Canada.
Centre de recherche interdisciplinaire en readaptation du Montreal metropolitain, Montreal, Quebec, Canada.
BMJ Open. 2023 May 23;13(5):e068866. doi: 10.1136/bmjopen-2022-068866.
INTRODUCTION: Stroke is a leading cause of morbidity and mortality worldwide, placing an immense burden on patients and the health system. Timely access to rehabilitation services can improve stroke survivors' quality of life. The use of standardised outcome measures is endorsed for optimising patient rehabilitation outcomes and improving clinical decision-making. This project results from a provincially mandated recommendation to use the fourth version of the Mayo-Portland Adaptability Inventory (MPAI-4) to measure changes in social participation of stroke survivors and to maintain commitment to evidence-informed practices in stroke care. This protocol outlines the implementation process of the MPAI-4 for three rehabilitation centres. The objectives are to: (a) describe the context of MPAI-4 implementation; (b) determine clinical teams' readiness for change; (c) identify barriers and enablers to implementing the MPAI-4 and match the implementation strategies; (d) evaluate the MPAI-4 implementation outcomes including the degree of integration of the MPAI-4 into clinical practice and (e) explore participants' experiences using the MPAI-4. METHODS AND ANALYSIS: We will use a multiple case study design within an integrated knowledge translation (iKT) approach with active engagement from key informants. Each case is a rehabilitation centre implementing MPAI-4. We will collect data from clinicians and programme managers using mixed methods guided by several theoretical frameworks. Data sources include surveys, focus groups and patient charts. We will conduct descriptive, correlational and content analyses. Ultimately, we will analyse, integrate data from qualitative and quantitative components and report them within and across participating sites. Results will provide insights about iKT within stroke rehabilitation settings that could be applied to future research projects. ETHICS AND DISSEMINATION: The project received Institutional Review Board approval from the Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal. We will disseminate results in peer-reviewed publications and at local, national and international scientific conferences.
简介:中风是全球发病率和死亡率的主要原因,给患者和医疗系统带来了巨大的负担。及时获得康复服务可以提高中风幸存者的生活质量。使用标准化的结果测量方法有助于优化患者的康复效果并改善临床决策。该项目源于省级授权,建议使用第四版 Mayo-Portland 适应性量表(MPAI-4)来衡量中风幸存者社会参与度的变化,并致力于在中风护理中坚持循证实践。本方案概述了三个康复中心实施 MPAI-4 的过程。目标是:(a)描述 MPAI-4 实施的背景;(b)确定临床团队对变革的准备情况;(c)确定实施 MPAI-4 的障碍和促进因素,并匹配实施策略;(d)评估 MPAI-4 的实施结果,包括 MPAI-4 融入临床实践的程度;(e)探讨参与者使用 MPAI-4 的经验。
方法与分析:我们将采用综合知识转化(iKT)方法中的多案例研究设计,并积极邀请关键利益相关者参与。每个案例都是一个实施 MPAI-4 的康复中心。我们将使用混合方法从临床医生和项目管理人员那里收集数据,这些方法由几个理论框架指导。数据来源包括调查、焦点小组和患者图表。我们将进行描述性、相关性和内容分析。最终,我们将分析、整合定性和定量部分的数据,并在参与的站点内和之间进行报告。结果将提供有关中风康复环境中 iKT 的见解,这些见解可应用于未来的研究项目。
伦理与传播:该项目已获得大蒙特利尔康复跨学科研究中心的机构审查委员会的批准。我们将在同行评议的出版物以及本地、国家和国际科学会议上传播研究结果。
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