Multidisciplinary team healthcare professionals' perceptions of current and optimal acute rehabilitation, a hip fracture example A UK qualitative interview study informed by the Theoretical Domains Framework.
Multidisciplinary team healthcare professionals' perceptions of current and optimal acute rehabilitation, a hip fracture example A UK qualitative interview study informed by the Theoretical Domains Framework.
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DOI：
10.1371/journal.pone.0277986
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发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
--
作者：
以髋部骨折为例，了解多学科团队医疗保健专业人员对当前和最佳急性康复提供的看法、感知的实施促进因素和障碍，以及它们对患者康复的影响。采用定性设计，采用半结构化电话采访方式对英国 15 家不同医院的骨科病房工作的急性多学科医疗团队的 20 名成员（职业治疗师、物理治疗师、医生、护士）进行访谈。访谈经过录音、逐字转录、匿名处理，然后利用理论领域框架进行主题分析，以增强我们对调查结果的理解。我们确定了四个主题：概念化康复实践模型，反映康复模型的感知可变性，以及最佳康复的促进者和常见患者和组织障碍；相互竞争的专业和组织目标，突出显示了组织目标与以人为本的护理塑造康复实践之间的不相容性，特别是对于更脆弱的患者；让团队参与协作实践，这与明确需要与多学科团队的所有成员良好合作以实现相同的以人为本的目标并分享康复实践有关；让患者及其护理人员参与进来，强调他们的参与对于在紧急情况下实现整体和协作康复方法的重要性。主题内的障碍和促进因素是由于缺乏或存在与患者、护理人员和多学科团队成员的适当沟通方式而造成的；资源（例如设备、人员配置、小组课程）以及管理层和高级职员等领导职位人员的支持。最佳急性康复的基石是多学科团队、患者和护理人员之间的有效沟通和协作实践。支持性管理和领导是优化这些流程的核心。组织限制是在医院环境中提供有效康复的最常见障碍，这加剧了筒仓工作并限制了患者的参与。
To understand multidisciplinary team healthcare professionals’ perceptions of current and optimal provision of acute rehabilitation, perceived facilitators and barriers to implementation, and their implications for patient recovery, using hip fracture as an example. A qualitative design was adopted using semi-structured telephone interviews with 20 members of the acute multidisciplinary healthcare team (occupational therapists, physiotherapists, physicians, nurses) working on orthopaedic wards at 15 different hospitals across the UK. Interviews were audio-recorded, transcribed verbatim, anonymised, and then thematically analysed drawing on the Theoretical Domains Framework to enhance our understanding of the findings. We identified four themes: conceptualising a model of rehabilitative practice, which reflected the perceived variability of rehabilitation models, along with facilitators and common patient and organisational barriers for optimal rehabilitation; competing professional and organisational goals, which highlighted the reported incompatibility between organisational goals and person-centred care shaping rehabilitation practices, particularly for more vulnerable patients; engaging teams in collaborative practice, which related to the expressed need to work well with all members of the multidisciplinary team to achieve the same person-centred goals and share rehabilitation practices; and engaging patients and their carers, highlighting the importance of their involvement to achieve a holistic and collaborative approach to rehabilitation in the acute setting. Barriers and facilitators within themes were underpinned by the lack or presence of adequate ways of communicating with patients, carers, and multidisciplinary team members; resources (e.g. equipment, staffing, group classes), and support from people in leadership positions such as management and senior staff. Cornerstones of optimal acute rehabilitation are effective communication and collaborative practices between the multidisciplinary team, patients and carers. Supportive management and leadership are central to optimise these processes. Organisational constraints are the most commonly perceived barrier to delivering effective rehabilitation in hospital settings, which exacerbate silo working and limited patient engagement.
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影响因子：
8.1
作者：
Long, AF;Kneafsey, R;Ryan, J
通讯作者：
Ryan, J
影响因子：
3.3
作者：
Donnellan, Claire;Sweetman, Susannah;Shelley, Emer
通讯作者：
Shelley, Emer
DOI：
10.1016/j.ijotn.2020.100778
发表时间：
2020-08-01
影响因子：
1.4
作者：
Jensen, Charlotte M.;Santy-Tomlinson, Julie;Clemensen, Jane
通讯作者：
Clemensen, Jane
DOI：
10.1302/0301-620x.103b7.bjj-2020-2349.r1
发表时间：
2021-07
期刊：
The bone & joint journal
影响因子：
--
作者：
Goubar A;Martin FC;Potter C;Jones GD;Sackley C;Ayis S;Sheehan KJ
通讯作者：
Sheehan KJ
影响因子：
2.9
作者：
Ropke A;Lund K;Thrane C;Juhl C;Morville AL
通讯作者：
Morville AL