利用知识转化行动框架改善脑震荡治疗中的物理治疗康复效果。

IF 1.3 4区 医学 Q3 REHABILITATION Journal of Sport Rehabilitation Pub Date : 2024-09-25 DOI:10.1123/jsr.2024-0078
Rebecca A Bliss, Lindsay Holland, Caitlin Fields, Kayley Stock
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引用次数: 0

摘要

背景:将新证据转化为临床实践是一个动态和反复的过程。针对脑震荡康复的研究在不断发展,需要采用植根于科学的系统方法将其转化为临床实践。知识到行动(KTA)循环框架是确保最佳结果和可持续性的有效策略。本研究的目的是利用 KTA 框架调查郊区医疗保健系统脑震荡管理的临床结果和临床医生自我效能的变化:设计:培训前和培训后干预研究:方法:对康复专业人员进行有针对性的脑震荡教育干预前后的电子调查。问题改编自一般自我效能量表,并专门针对当前脑震荡管理中的信心问题进行了调整。此外,还完成了知识转化教育干预前后的病历回顾,以检查实践模式。利用预调查和回顾性病历审查的数据来确定 "知与行 "之间的差距,并设计有针对性的教育干预措施。统计分析采用 SPSS(28 版)进行:组内差异显示,物理治疗师对脑震荡管理中的评估(P = .01)、干预(P = .01)和咨询(P = .01)的信心有所增强。将参与干预的物理治疗师与未参与干预的物理治疗师进行比较,发现参与教育干预的物理治疗师在所有方面的自信心都显著提高(P ≤ .001)。事后病历回顾显示,临床实践模式在以下方面有所改进:使用患者报告的结果测量(P ≤ .001)、客观结果测量(P = .002)、用力测试(P ≤ .001)、完成综合评估(P ≤ .001)和使用循证实践(P ≤ .001):结论:使用 KTA 框架提高了临床医生的自我效能,改善了医院门诊脑震荡治疗的临床实践模式。KTA框架是一种潜在的工具,可用于转化与脑震荡管理相关的现有证据,以改善临床效果。
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Use of Knowledge Translation Action Framework to Improve Physical Therapy Rehabilitation Outcomes in Concussion Management.

Context: Translating new evidence into clinical practice is a dynamic and iterative process. Research is ever evolving specific to concussion rehabilitation and requires a systematic approach rooted in science for translation into clinical practice. The knowledge-to-action (KTA) cycle framework is an effective strategy to ensure optimal outcomes and sustainability. The objective of this study was to investigate changes in clinical outcomes and clinician self-efficacy specific to concussion management in a suburban health care system utilizing the KTA framework.

Design: Pretraining and posttraining intervention study.

Methods: Rehabilitation professionals were electronically surveyed pre-post targeted concussion educational intervention. Questions were adapted from the General Self-Efficacy scale and tailored specifically to confidence in current concussion management. Retrospective chart reviews were also completed pre-post knowledge translation educational intervention to examine practice patterns. Data from the presurvey and retrospective chart review were utilized to identify the know-do gap and design intentional educational interventions. Statistical analysis was performed utilizing SPSS (version 28).

Results: Within-group differences revealed an increase in confidence with evaluation (P = .01), intervention (P = .01), and consultation (P = .01) in concussion management. When comparing physical therapists who participated in the intervention with those who did not, there was significantly higher self-confidence in all areas (P ≤ .001) for those who engaged in the educational intervention. Pre-post chart reviews revealed improvement in clinical practice patterns in the following constructs: use of patient-reported outcome measures (P ≤ .001), objective outcome measures (P = .002), exertional testing (P ≤ .001), completion of comprehensive evaluation (P ≤ .001), and use of evidence-based practice (P ≤ .001).

Conclusions: Utilizing the KTA framework resulted in improved self-efficacy of clinicians as well as improved clinical practice patterns in concussion management in an outpatient hospital-based practice. The KTA framework is a potential tool for translating current evidence related to concussion management for improved clinical outcomes.

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来源期刊
Journal of Sport Rehabilitation
Journal of Sport Rehabilitation 医学-康复医学
CiteScore
3.20
自引率
5.90%
发文量
143
审稿时长
>12 weeks
期刊介绍: The Journal of Sport Rehabilitation (JSR) is your source for the latest peer-reviewed research in the field of sport rehabilitation. All members of the sports-medicine team will benefit from the wealth of important information in each issue. JSR is completely devoted to the rehabilitation of sport and exercise injuries, regardless of the age, gender, sport ability, level of fitness, or health status of the participant. JSR publishes peer-reviewed original research, systematic reviews/meta-analyses, critically appraised topics (CATs), case studies/series, and technical reports that directly affect the management and rehabilitation of injuries incurred during sport-related activities, irrespective of the individual’s age, gender, sport ability, level of fitness, or health status. The journal is intended to provide an international, multidisciplinary forum to serve the needs of all members of the sports medicine team, including athletic trainers/therapists, sport physical therapists/physiotherapists, sports medicine physicians, and other health care and medical professionals.
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