Field Leanne, Nagy Liana, Knaggs Tarnya, Collett Johnny
Centre for Movement, Occupational and Rehabilitation Sciences, Oxford Brookes University, Oxford, UK.
Adult Social Care, Wokingham Borough Council, Berkshire, UK.
Br J Occup Ther. 2024 Aug;87(8):466-476. doi: 10.1177/03080226241246511. Epub 2024 Apr 15.
Despite practice guidelines, professionals do not feel confident in implementing positive risk-taking. This may be due to the guidance provided.
A scoping review of current organisational guidance for the professional practice of positive risk-taking within Adult Social Care services for people with a physical disability. Guidelines were obtained from Local Authorities in England in October 2020. The data were extracted using TIDieR to describe positive risk-taking as an intervention. The quality of the guidelines was assessed using AGREE II.
In all, 36 Local Authorities responded out of 106 contacted. A total of 21 documents were included for review. Substantial variability was found in terminology, definitions and risk grading between documents. The greatest consistency was found in how to implement a positive risk-taking intervention. Consistency was also found in the policy that documents cited. There was little reference to evidence to support intervention components. Overall, AGREE II quality scores were low and stakeholder involvement, specifically with regard to the views and preferences of service users, was largely absent.
There is a need for a greater consensus to guide the professional practice of positive risk-taking. Determining the extent of current evidence and establishing an evidence base may facilitate more consistent guidelines and support professionals' confidence in implementing positive risk-taking.
尽管有实践指南,但专业人员在实施积极冒险方面缺乏信心。这可能归因于所提供的指导。
对成人社会护理服务中为身体残疾者提供积极冒险专业实践的当前组织指南进行范围审查。指南于2020年10月从英格兰地方当局获取。使用TIDieR提取数据,将积极冒险描述为一种干预措施。使用AGREE II评估指南的质量。
在106个被联系的地方当局中,共有36个做出了回应。总共纳入21份文件进行审查。各文件之间在术语、定义和风险分级方面存在很大差异。在如何实施积极冒险干预措施方面一致性最高。文件引用的政策方面也存在一致性。几乎没有提及支持干预措施组成部分的证据。总体而言,AGREE II质量得分较低,且很大程度上缺乏利益相关者的参与,特别是服务用户的观点和偏好。
需要达成更大的共识来指导积极冒险的专业实践。确定当前证据的范围并建立证据基础可能有助于制定更一致的指南,并增强专业人员实施积极冒险的信心。