17 results on '"Grimmer, Karen"'
Search Results
2. How to contextualize training on guideline‐uptake for your setting.
- Author
-
Stander, Jessica, Grimmer, Karen, and Brink, Yolandi
- Subjects
- *
PROFESSIONAL practice , *PHYSICAL therapy , *EVIDENCE-based medicine , *THEORY-practice relationship , *MEDICAL protocols - Abstract
One knowledge translation method, of putting evidence into practice, is the use of clinical practice guidelines (CPG). The purpose of this brief report is to describe an 8‐step process of "how to" contextualize a training programme to increase CPG‐uptake for a targeted audience in a clearly defined setting. This process may assist implementation practitioners to fast‐track the development of contextualized training to improve CPG‐uptake. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
3. Time as a barrier to evidence uptake—A qualitative exploration of the concept of time for clinical practice guideline uptake by physiotherapists.
- Author
-
Stander, Jessica, Grimmer, Karen, and Brink, Yolandi
- Subjects
- *
PROFESSIONAL practice , *TIME , *ATTITUDE (Psychology) , *CHANGE , *EVIDENCE-based medicine , *INTERVIEWING , *MEDICAL protocols , *QUALITATIVE research , *TRANSTHEORETICAL model of change , *THEMATIC analysis , *TIME management , *PHYSICAL therapists' attitudes , *BEHAVIOR modification - Abstract
Background: Lack of time has consistently been reported as a major barrier to effective research evidence uptake into clinical practice. There has been no research to our knowledge that explores time as a barrier within the transtheoretical model of stages of change (SoC), to better understand the processes of physiotherapists' uptake of clinical practice guidelines (CPGs). This article explores the concept of lack of time as a barrier for CPG uptake for physiotherapists at different SoC. Methods: A six‐step process is presented to determine the best‐fit SoC for 31 physiotherapy interviewees. This process used an amalgamation of interview findings and socio‐demographic data, which was layered onto the SoC and previously identified time‐barriers to CPG uptake (few staff, high workload, access to CPGs, evidence‐based practice as priority in clinical practice, 'time is money' attitude and knowledge on the use of CPGs). Results: The analysis process highlighted the complexities of assigning individuals to a SoC. A model of time management for better CPG uptake is proposed which is a novel approach to assist evidence implementalists and clinicians alike to determine how to progress through the SoC and barriers to improve CPG uptake. Conclusions: To the authors' knowledge, this is the first attempt at exploring the construct of (lack of) time for CPG uptake in relation to the physiotherapists' readiness to behaviour change. This study shows that 'lack of time' is a euphemism for quite different barriers, which map to different stages of readiness to embrace current best evidence into physiotherapy practice. By understanding what is meant by 'lack of time', it may indicate specific support required by physiotherapists at different stages of changing these behaviours. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
4. Tailored training for physiotherapists on the use of clinical practice guidelines: A mixed methods study.
- Author
-
Stander, Jessica, Grimmer, Karen, and Brink, Yolandi
- Subjects
- *
CONFIDENCE , *DISCUSSION , *RESEARCH methodology , *MEDICAL protocols , *PHYSICAL therapy , *PRIMARY health care , *PROFESSIONS , *RESEARCH , *RESEARCH funding , *T-test (Statistics) , *PAIN management , *EVIDENCE-based medicine , *PILOT projects , *HUMAN services programs , *EVALUATION of human services programs , *DESCRIPTIVE statistics , *LUMBAR pain - Abstract
Introduction: Clinical practice guidelines (CPG) are vehicles for translating evidence into practice, but effective CPG‐uptake requires targeted training. This mixed methods research project took a staged evidence‐based approach to develop and test a tailored training programme (TTP) that addressed organisational and individual factors influencing CPG‐uptake by South African physiotherapists treating patients with low back pain in primary healthcare settings. Methods: This multi‐stage mixed methods study reports the development, contextualisation and expert content validation of a TTP to improve CPG‐uptake. Finally, the TTP was evaluated for its feasibility and acceptability in its current format. Results: The TTP (delivered online and face‐to‐face) contained minimal theory, and focussing on practical activities, clinical scenarios and discussions. Pre‐TTP, physiotherapists expressed skepticism about the relevance of CPG in daily practice. However, post‐TTP they demonstrated improved knowledge, confidence, and commitment to CPG‐uptake. Discussion: The phased‐construction of the TTP addressed South African primary healthcare physiotherapists' needs and concerns, using validated evidence‐based educational approaches. The TTP content, delivered by podcasts and face‐to‐face contact, was feasible and acceptable in terms of physiotherapists' time constraints, and it appeared to be effective in improving all outcome domains. This TTP is now ready for intervention to a wider audience. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
5. Factors influencing clinical practice guideline uptake by South African physiotherapists: A qualitative investigation of barriers and facilitators.
- Author
-
Stander, Jessica, Grimmer, Karen, and Brink, Yolandi
- Subjects
- *
CONFIDENCE , *CONTENT analysis , *LABOR incentives , *INTERVIEWING , *LABOR supply , *PHENOMENOLOGY , *RESEARCH methodology , *MEDICAL care , *MEDICAL protocols , *MEDICAL practice , *PAY for performance , *PHYSICAL therapists , *PROFESSIONAL ethics , *RESEARCH , *RESPONSIBILITY , *REWARD (Psychology) , *TELEPHONES , *WORK environment , *QUALITATIVE research , *PRIVATE sector , *PUBLIC sector , *OCCUPATIONAL roles , *PSYCHOSOCIAL factors , *SOCIAL boundaries , *THEMATIC analysis - Abstract
Rationale: Clinical practice guidelines (CPGs) should provide busy health care professionals with easy‐to‐use tools that support efficient uptake of current best evidence in daily clinical practice. However, CPG uptake rarely occurs at the speed of evidence production. The aim of this study was to explore the factors influencing CPG uptake among South African (SA) physiotherapists (PTs). Method: An exploratory, descriptive qualitative study design was used, within an interpretative research paradigm. A phenomenological approach was taken, as the study aimed to explore the phenomenon of CPG uptake by SA PTs and how the themes and subthemes related to each other within this phenomenon. Semistructured interviews were undertaken via telephone calls that were audiotaped and independently transcribed. An inductive and deductive thematic content analysis approach was taken where the transcript content was analysed by hand. Findings Thirty‐one PTs from the private, public, and education sectors participated in the interviews. The main themes identified were resources, training, and organizational factors. The SA PT workforce, particularly that in the public sector, is limited and patient load and need is high. Time to implement and stay up‐to‐date with current evidence were barriers for many interviewees. Participants also perceived CPG uptake as not being financially rewarding. Training in CPG uptake was mostly perceived as a facilitator, and the PTs felt that they would be more inclined to implement CPGs if they felt more confident in how to source and use CPGs, particularly if they were incentivized to undertake such training. Roles, responsibilities, and power in the health care team were perceived as being both organizational barriers and, conversely, facilitators, depending on work environments. Conclusions: The findings of this study generally concur with previous studies about PT barriers to CPG uptake; however, it provides novel information on barrier contexts in one LMIC with complex PT service delivery. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
6. A user-friendly clinical practice guideline summary for managing low back pain in South Africa.
- Author
-
Stander, Jessica, Grimmer, Karen, and Brink, Yolandi
- Subjects
- *
CONSENSUS (Social sciences) , *INTELLECT , *INTERVIEWING , *MEDICAL protocols , *HEALTH outcome assessment , *SCALE analysis (Psychology) , *PAIN management , *EVIDENCE-based medicine , *PROFESSIONAL practice , *DESCRIPTIVE statistics , *LUMBAR pain - Abstract
Background: Clinical practice guidelines (CPGs) provide conveniently packaged evidence-based recommendations to inform clinical decisions. However, intended end-users often do not know how to source, appraise, interpret or choose among CPGs. Moreover, it can be confusing when recommendations on the same topic differ among CPGs, in wording, intent and underpinning evidence. Objectives: This article reports on the processes of: (1) identifying current CPGs for acute and subacute low back pain (LBP) to fit the needs of South African physiotherapists, (2) collating and summarising CPG recommendations to produce a user-friendly end-user product and (3) testing the utility of the summary CPG document on South African physiotherapy clinicians to efficiently determine acceptability, appropriateness and feasibility to inform clinical decision-making. Method: An adapted approach was followed by systematically searching online CPG repositories and online databases for LBP CPGs; screening and critically appraising identified CPGs; summarising recommendations from relevant CPGs and organising them into clinical practice activities. Feedback on utility was obtained from 11 physiotherapists. Results: Three high-quality, international CPGs provided 25 recommendations on the assessment and management of acute and subacute LBP relevant to South African physiotherapy practice. They were organised into 10 headings. Physiotherapy user feedback suggested that this document would assist in clinical decision-making. Conclusion: Organised recommendations extracted from multiple, relevant CPGs provide an end-user-friendly resource for physiotherapists treating LBP. Clinical implications: Collated and organised CPG recommendations may effectively assist South African physiotherapists' clinical decision-making in assessing and managing patients with acute and subacute LBP. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
7. Training programmes to improve evidence uptake and utilisation by physiotherapists: a systematic scoping review.
- Author
-
Stander, Jessica, Grimmer, Karen, and Brink, Yolandi
- Subjects
MEDICAL research ,PHYSICAL therapists ,EVIDENCE-based medicine ,DECISION making in clinical medicine ,SYSTEMATIC reviews - Abstract
Background: Research training programmes are a knowledge translation (KT) intervention which aim to improve research evidence uptake by clinicians. Whilst KT training programmes have been reported to significantly improve evidence uptake by physiotherapists, it is unclear which aspects of training optimally assist KT into physiotherapy practice. The purpose of the review was to establish the body of evidence regarding KT training programmes to improve physiotherapists' use of evidence-based practice (EBP) and clinical practice guidelines (CPG). Methods: A systematic scoping review was undertaken in line with the adapted Arksey and O'Malley framework. Nine electronic databases (CINAHL, BIOMED CENTRAL, Cochrane, Web of Science, PROQUEST, PUBMED, OTseeker, Scopus, ERIC) were searched. Targeted keywords identified primary research articles of any hierarchy, that described the nature and impact of KT training programmes for physiotherapists. Where systematic reviews were identified, the component primary studies were considered individually for relevance. Critical appraisal was not undertaken due to the nature of a scoping review, and data was reported descriptively. Results: Ten systematic reviews were identified (yielding four relevant primary studies). Five additional primary studies were identified (two randomised controlled trials, two non-randomised controlled trials and one pre-post study) which were not included in the original systematic reviews. This provided nine eligible primary research studies for review. The KT strategies were all multi-faceted. Interactive sessions, didactic sessions, printed material and discussion and feedback were consistently associated with effective outcomes. When KT strategies addressed local barriers to EBP utilisation, there were better success rates for EBP and CPG uptake, irrespective of the outcome measures used. There were no consistent ways of measuring outcome. Conclusion: Multi-faceted KT strategies designed to address local barriers to knowledge translation were most effective in improving EBP/ CPG uptake among physiotherapists. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
8. A systematic review protocol on the effectiveness of therapeutic exercises utilised by physiotherapists to improve function in patients with burns.
- Author
-
Mudawarima, Tapfuma, Chiwaridzo, Matthew, Jelsma, Jennifer, Grimmer, Karen, and Muchemwa, Faith Chengetayi
- Subjects
TREATMENT for burns & scalds ,SYSTEMATIC reviews ,MEDICAL protocols - Abstract
Background: Therapeutic exercises play a crucial role in the management of burn injuries. The broad objective of this review is to systematically evaluate the effectiveness, safety and applicability to low-income countries of therapeutic exercises utilised by physiotherapists to improve function in patients with burns. Population = adults and children/adolescents with burns of any aspect of their bodies. Interventions = any aerobic and/or strength exercises delivered as part of a rehabilitation programme by anyone (e.g. physiotherapists, occupational therapists, nurses, doctors, community workers and patients themselves). Comparators = any comparator. Outcomes = any measure of outcome (e.g. quality of life, pain, muscle strength, range of movement, fear or quality of movement). Settings = any setting in any country. Methods/design: A systematic review will be conducted by two blinded independent reviewers who will search articles on PubMed, CiNAHL, Cochrane library, Medline, Pedro, OTseeker, EMBASE, PsychINFO and EBSCOhost using predefined criteria. Studies of human participants of any age suffering from burns will be eligible, and there will be no restrictions on total body surface area. Only randomised controlled trials will be considered for this review, and the methodological quality of studies meeting the selection criteria will be evaluated using the Cochrane Collaboration tool for assessing risk of bias. The PRISMA reporting standards will be used to write the review. A narrative analysis of the findings will be done, but if pooling is possible, meta-analysis will be considered. Discussion: Burns may have a long-lasting impact on both psychological and physical functioning and thus it is important to identify and evaluate the effects of current and past aerobic and strength exercises on patients with burns. By identifying the characteristics of effective exercise programmes, guidelines can be suggested for developing intervention programmes aimed at improving the function of patients with burns. The safety and precautions of exercise regimes and the optimal frequency, duration, time and intensity will also be examined to inform further intervention. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
9. Evidence-Based Physiotherapy for Acute Low Back Pain: A Composite Clinical Algorithm Synthesized from Seven Recent Clinical Guidelines.
- Author
-
Holohan, Vanessa, Deenadayalan, Yamini, and Grimmer, Karen
- Subjects
PHYSICAL therapy ,LUMBAR pain ,EVIDENCE-based medicine ,PHYSICAL therapists ,MEDICAL protocols ,CLINICAL medicine handbooks - Abstract
Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2006
- Full Text
- View/download PDF
10. Physiotherapy for female stress urinary incontinence: a multicentre observational study.
- Author
-
Neumann, Patricia B., Grimmer, Karen A., Grant, Ruth E., and Gill, Virginia A.
- Subjects
- *
PHYSICAL therapy , *THERAPEUTICS , *URINARY incontinence , *HEALTH outcome assessment , *PELVIC floor - Abstract
No previous data are available on the effectiveness of physiotherapy management of urinary stress incontinence with relevance to the Australian health system. To evaluate Australian ambulatory physiotherapy management of stress urinary incontinence. Observational multicentre clinical study of physiotherapy management of female stress urinary incontinence between February 1999 and October 2000, with 1-year follow-up. Outcome measures were a stress test and a 7-day diary of incontinent episodes (pretreatment and at every visit) and a condition-specific quality of life (QoL) questionnaire (pre- and post-treatment). Subjects were followed-up 1 year after treatment by questionnaire with a 7-day diary, QoL questionnaire, and assessment of subjective outcome, subjective cure, satisfaction and need for surgery. Of the 274 consenting subjects, 208 completed an episode of physiotherapy care consisting of a median (IQ range) of five (four to six) visits. At the end of the episode, 84% were cured and 9% improved on stress testing, whilst 53% were cured and 25% improved according to the 7-day diary. Mean volume of urine loss on stress testing reduced from 2.4 (2.5) mL to 0.1(0.4) mL after treatment. There was a significant improvement in all QoL domains. Median (interquartile range) incontinent episodes per week were reduced from five (three to 11) to zero (zero to two) ( P < 0.05) after treatment and to one (zero to four) at 1 year ( P < 0.05). At 1 year, approximately 80% of respondents had positive outcomes on all outcome measures. Physiotherapy management in Australian clinical settings is an effective treatment option for women with stress urinary incontinence. [ABSTRACT FROM AUTHOR]
- Published
- 2005
- Full Text
- View/download PDF
11. Effectiveness of primary conservative management for infants with obstetric brachial plexus palsy.
- Author
-
Bialocerkowski, Andrea, Kurlowicz, Kirsty, Vladusic, Sharon, and Grimmer, Karen
- Subjects
PRIMARY care ,BRACHIAL plexus diseases ,JUVENILE diseases ,CHILDBIRTH ,DELIVERY (Obstetrics) - Abstract
Obstetric brachial plexus palsy, a complication of childbirth, occurs in 1–3 per 1000 live births internationally. Traction and/or compression of the brachial plexus is thought to be the primary mechanism of injury and this may occurin utero, during the descent through the birth canal or during delivery. This results in a spectrum of injuries that vary in severity, extent of damage and functional use of the affected upper limb. Most infants receive treatment, such as conservative management (physiotherapy, occupational therapy) or surgery; however, there is controversy regarding the most appropriate form of management. To date, no synthesised evidence is available regarding the effectiveness of primary conservative management for obstetric brachial plexus palsy.The objective of this review was to systematically assess the literature and present the best available evidence that investigated the effectiveness of primary conservative management for infants with obstetric brachial plexus palsy.A systematic literature search was performed using 14 databases: TRIP, MEDLINE, CINAHL, AMED, Web of Science, Proquest 5000, Evidence Based Medicine Reviews, Expanded Academic ASAP, Meditext, Science Direct, Physiotherapy Evidence Database, Proquest Digital Dissertations, Open Archives Initiative Search Engine, Australian Digital Thesis Program. Those studies that were reported in English and published over the last decade (July 1992 to June 2003) were included in this review.Quantitative studies that investigated the effectiveness of primary conservative management for infants with obstetric brachial plexus palsy were eligible for inclusion in this review. This excluded studies that solely investigated the effect of primary surgery for these infants, management of secondary deformities and the investigation of the effects of pharmacological agents, such as botulinum toxin.Two independent reviewers assessed the eligibility of each study for inclusion into the review, the study design used and its methodological quality. Where any disagreement occurred, consensus was reached by discussion. Studies were assessed for clinical homogeneity by considering populations, interventions and outcomes. Where heterogeneity was present, synthesis was undertaken in a narrative format.Eight studies were included in the review. Most were ranked low on the Hierarchy of Evidence (no randomised controlled trials were found), and had only fair methodological quality. Conservative management was variable and could consist of active or passive exercise, splints or traction. All studies lacked a clear description of what constituted conservative management, which would not allow the treatment to be replicated in the clinical setting. A variety of outcome instruments were used, none of which had evidence of validity, reliability or sensitivity to detect change. Furthermore, less severely affected infants were selected to receive conservative management. Therefore, it is difficult to draw conclusions regarding the effectiveness of conservative management for infants with obstetric brachial plexus palsy.There is scant, inconclusive evidence regarding the effectiveness of primary conservative intervention for infants with obstetric brachial plexus palsy. Further research should be directed to develop outcome instruments with sound psychometric properties for infants with obstetric brachial plexus palsy and their families. These outcome instruments should then be used in well-designed comparative studies. [ABSTRACT FROM AUTHOR]
- Published
- 2005
- Full Text
- View/download PDF
12. Burn injuries in Zimbabwe: development of guidelines for physiotherapy rehabilitation of musculoskeletal impairments and functional limitations
- Author
-
Mudawarima, Tapfuma, Jelsma, Jennifer, and Grimmer Karen
- Subjects
Musculoskeletal ,Rehabilitation ,Guidelines ,Function ,Burns ,Physiotherapy - Abstract
Background and need: Burn injuries are a major cause of hospital admission in low-income countries such as Zimbabwe and often lead to secondary complications such as disfigurements, contractures, and scar formations. The study aimed to establish “Guidelines for Rehabilitation of Musculoskeletal Impairments and Functional Limitations for Zimbabwe for Patients with Burns” based on the best evidence available. There were three good candidates for use as the source guideline, but ultimately, the Agency for Clinical Innovation (ACI) of New South Wales in Australia guidelines1 was chosen. The contextualisation of these guidelines for the Zimbabwean situation was informed by the outcomes of five sub-studies. A summary of the methodologies applied and the key results follow. Methods and Results: The Epidemiology of Burns in Zimbabwe: The characteristics of patients with burns in Zimbabwe was established through a retrospective record review (descriptive review) to characterise patients admitted with burns to the two central hospitals in Harare over fifteen months. The sample consisted of 926 admission records and 435 full patient folders were retrieved and analysed. Unfortunately, 425 full folders of children were missing and 85 folders of adults. There was a clear difference in presentation between children and adults, with children constituting over threequarters of all admissions, but with less severe injuries. Post-discharge follow-up: Access to rehabilitation and impact on Health-Related Quality of Life (HRQoL): The second study investigated the utilisation of post-discharge care, regarding referral after discharge and home programme. This was a study with a small sample, 14 adult and 23 child respondents. Despite referrals having been made to local rehabilitation departments, there was practically no further post-discharge contact with rehabilitation and only a single person received post-discharge rehabilitation. Both Health-Related Quality of Life (HRQoL) instruments used by the adult respondents indicated less impact on physical domains of functioning with the greatest impact in pain and emotional well-being. In the absence of trained counsellors, rehabilitation therapists might need to step into this role. Systematic review: The broad objective of this review was to systematically evaluate the effectiveness, safety and applicability to low-income countries of therapeutic exercises utilised by physiotherapists to improve function in patients with burns. The review, which included 19 papers, established that exercises (either resistance or aerobic), are effective and generally have a positive effect on muscle strength and aerobic capacity. However, there was a risk of bias in many of the papers and the evidence is not of high quality. As most of the research enrolled paediatric patients older than seven years and no adverse effects were reported, it can be concluded that resistance exercise is safe for this group of patients. However, as most children admitted with burns are younger than seven years, exercise needs to be carefully monitored in this group as safety and efficacy have not been proven for younger children. iii The results from this support the use of aerobic and resistance as an important component of a burn rehabilitation program as they have shown to improve muscle strength aerobic capacity and functional status even after hospital discharge, especially in patients with severe burns. Documentation of the current rehabilitation practice: This phase documented clinical interventions used to treat musculoskeletal problems by observation of seven rehabilitation workers (not only physiotherapists), based in the five central hospitals, one provincial and one district hospital. The treatments of five adults and five paediatric patients were observed at each hospital, a total of 70 treatments in all. The most significant finding was that the management of patients with burns was offered by a single rehabilitation worker a Physiotherapists (PT), Occupational Therapists (OT) or Rehabilitation Technician (RT), working in Burns' Units without any specialised training or additional courses. The management of burns across all hospitals was similar, and information saturation was reached with the planned number of observations. Passive and active movements were used almost universally, and the patients received a ward programme, which included positioning. Sitting and standing were included in some patients and patients were monitored for any adverse effects. A major weakness observed was the lack of baseline assessment or treatment progress during treatment. No compression bandages were applied and no scar tissue massage was done. Identification and adaptation of the suitable guidelines: Following a literature search and examination of different guidelines by two independent reviewers, the Agency for Clinical Innovation of New South Wales, Australia1 was chosen as a candidate for amendment. The guidelines were amended based on the results of the previous studies and subjected to a Delphi process with four to six Zimbabwean rehabilitation therapists who were experienced in the field of burn management. A credible set of guidelines for Zimbabwe for the rehabilitation of musculoskeletal impairments and functional limitations was thus produced. Conclusion: The current study adds to the body of knowledge through the development of guidelines for the physiotherapy rehabilitation of musculoskeletal impairments and functional limitations for patients with burns in low- and middle-income countries. The thesis has provided an evidence-based framework for patients, rehabilitation workers and policymakers to inform the provision of effective management of patients with burns. The Zimbabwe Guidelines should be regarded as a first attempt rather than the final version and hopefully will be subjected to further review as they are tried out in practice.
- Published
- 2022
13. Training programmes to improve evidence uptake and utilisation by physiotherapists: A systematic scoping review
- Author
-
Karen Grimmer, Yolandi Brink, Jessica Stander, Stander, Jessica, Grimmer, Karen, and Brink, Yolandi
- Subjects
Health Knowledge, Attitudes, Practice ,knowledge translation ,Evidence-based practice ,Scopus ,evidence-based practice ,lcsh:Medicine ,CINAHL ,Knowledge translation ,Education ,Translational Research, Biomedical ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,030212 general & internal medicine ,Physiotherapy ,Physical Therapy Modalities ,physiotherapy ,Research evidence ,lcsh:LC8-6691 ,Medical education ,lcsh:Special aspects of education ,business.industry ,030503 health policy & services ,lcsh:R ,General Medicine ,Physical Therapists ,Critical appraisal ,Systematic review ,Clinical practice guidelines ,0305 other medical science ,business ,clinical practice guidelines ,Research Article ,Primary research - Abstract
Background Research training programmes are a knowledge translation (KT) intervention which aim to improve research evidence uptake by clinicians. Whilst KT training programmes have been reported to significantly improve evidence uptake by physiotherapists, it is unclear which aspects of training optimally assist KT into physiotherapy practice. The purpose of the review was to establish the body of evidence regarding KT training programmes to improve physiotherapists’ use of evidence-based practice (EBP) and clinical practice guidelines (CPG). Methods A systematic scoping review was undertaken in line with the adapted Arksey and O’Malley framework. Nine electronic databases (CINAHL, BIOMED CENTRAL, Cochrane, Web of Science, PROQUEST, PUBMED, OTseeker, Scopus, ERIC) were searched. Targeted keywords identified primary research articles of any hierarchy, that described the nature and impact of KT training programmes for physiotherapists. Where systematic reviews were identified, the component primary studies were considered individually for relevance. Critical appraisal was not undertaken due to the nature of a scoping review, and data was reported descriptively. Results Ten systematic reviews were identified (yielding four relevant primary studies). Five additional primary studies were identified (two randomised controlled trials, two non-randomised controlled trials and one pre-post study) which were not included in the original systematic reviews. This provided nine eligible primary research studies for review. The KT strategies were all multi-faceted. Interactive sessions, didactic sessions, printed material and discussion and feedback were consistently associated with effective outcomes. When KT strategies addressed local barriers to EBP utilisation, there were better success rates for EBP and CPG uptake, irrespective of the outcome measures used. There were no consistent ways of measuring outcome. Conclusion Multi-faceted KT strategies designed to address local barriers to knowledge translation were most effective in improving EBP/ CPG uptake among physiotherapists. Electronic supplementary material The online version of this article (doi: 10.1186/s12909-018-1121-6) contains supplementary material, which is available to authorized users.
- Published
- 2018
14. Physiotherapy students’ and clinical teachers’ perspectives on best clinical teaching and learning practices: A qualitative study
- Author
-
E. Bitzer, Dawn Ernstzen, K. Grimmer-Somers, Ernstzen, D.V, Bitzer, E, and Grimmer, Karen Anne
- Subjects
education ,Medical education ,medicine.medical_specialty ,business.industry ,Best practice ,lcsh:RC952-1245 ,best practice ,lcsh:Special situations and conditions ,Physical Therapy, Sports Therapy and Rehabilitation ,teaching ,Formative assessment ,Learning opportunities ,Physical therapy ,medicine ,clinical training ,teaching and learning ,Clinical competence ,Clinical education ,business ,Clinical teaching ,physiotherapy ,Qualitative research ,clinical training/education - Abstract
Background: Clinical education forms a core component of the training of physiotherapy students. Little research on the efficacy of commonly used physiotherapy clinical learning and teaching opportunities are available. Objective: This paper sought to identify the clinical teaching and learning opportunities that undergraduate physiotherapy students and clinical teachers viewed as effective in enhancing learning, as well as the reasoning behind their views.Design: A qualitative research design was used. Data was analyzed using content analysis. Data was coded, cate gorized and conceptualized into key themes and patterns. Participants: All third year (n=40) and fourth year (n=40) physiotherapy students as well as their clinical teachers (n=37) were eligible to participate. Semi-structured individual interviews were conducted with a purposive sample consisting of six third-year students, six fourth-year students and six clinical teachers. Results: The results indicated that learning is best facilitated in open, relaxed environments.Demonstrations of patient management by teachers and students, discussion of patient cases, feedback and formative assessment were identified to be effective strategies to enhance development of clinical competence. Conclusion: Clinical education, using focused and structured processes, could ensure that students are exposed to a range of learning opportunities for development of clinical competence.
- Published
- 2010
15. Physiotherapy for female stress urinary incontinence
- Author
-
Grant, Elinor Ruth, Neumann,Patricia Briar, Grimmer, Karen Anne, and Gill, Virginia
- Subjects
outcomes research ,pelvic floor ,treatment outcome ,urinary stress incontinence ,physiotherapy - Published
- 2005
16. The role of extended scope physiotherapists in managing patients with infammatory arthropathies: A systematic review
- Author
-
Kate Beaton, Jessica Stanhope, Karen Grimmer-Somers, Joanne Morris, Stanhope, Jessica, Beaton, Kate, Grimmer, Karen Anne, and Morris, Joanne
- Subjects
rheumatoid arthritis ,medicine.medical_specialty ,Scope of practice ,Alternative medicine ,Review ,Diseases of the musculoskeletal system ,English language ,inflammatory arthropathy ,Hierarchy of evidence ,fluids and secretions ,extended scope ,Rheumatology ,ankylosing spondylitis ,medicine ,ESP ,physiotherapy ,National health ,Ankylosing spondylitis ,Scope (project management) ,business.industry ,biochemical phenomena, metabolism, and nutrition ,medicine.disease ,RC925-935 ,Family medicine ,Physical therapy ,Level iii ,business - Abstract
Jessica Stanhope,1 Kate Beaton,1 Karen Grimmer-Somers,1 Joanne Morris21International Centre for Allied Health Evidence (iCAHE), University of South Australia, Adelaide, South Australia; 2ACT Government Health Directorate, Canberra, Australian Capital Territory, AustraliaObjectives: To review the literature to identify whether, and how, physiotherapists working in extended scope of practice (ESP) engage with patients with inflammatory arthropathies. Measures of effectiveness of ESP were particularly sought.Methods: A comprehensive library database search was conducted to identify English language studies published in full text in peer-reviewed journals during the years 2002–2012. Studies were allocated into the National Health and Medical Research Council hierarchy of evidence, but were not critically appraised. Data was extracted on conditions treated, ESP roles and responsibilities, and effectiveness. Data was analyzed and reported descriptively.Results: We identified 123 studies, and included four. All were low hierarchy (highest being one level III_2 study). Commonly reported conditions were rheumatoid arthritis and ankylosing spondylitis. Information was provided on activities of role extension, such as triaging patients, monitoring and recommending changes to medications, referring to other health and medical professionals, and ordering and interpreting imaging. There was blurring between ESP and non-ESP roles. No study reported measures of effectiveness.Conclusion: There are descriptors of ESP physiotherapy activities, but no evidence of effectiveness of ESP physiotherapy in managing patients with inflammatory arthropathies.Keywords: ESP, extended scope, rheumatoid arthritis, ankylosing spondylitis, inflammatory arthropathy, physiotherapy
17. Pelvic floor muscle training and adjunctive therapies for the treatment of stress urinary incontinence in women: a systematic review
- Author
-
Patricia Neumann, Karen Grimmer, Yamini Deenadayalan, Neumann,Patricia Briar, Grimmer, Karen Anne, and Deenadayalan, Yamini
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Clinical Sciences ,Alternative medicine ,MEDLINE ,Reproductive medicine ,Urinary incontinence ,Biofeedback ,lcsh:Gynecology and obstetrics ,systematic Review ,Obstetrics and Gynaecology ,medicine ,Physiotherapy ,lcsh:RG1-991 ,Medicine(all) ,business.industry ,Clinical study design ,lcsh:Public aspects of medicine ,Obstetrics and Gynecology ,lcsh:RA1-1270 ,General Medicine ,Evidence-based medicine ,Pelvic Floor ,Reproductive Medicine ,Physical therapy ,medicine.symptom ,business ,Research Article ,Cohort study - Abstract
Background Stress urinary incontinence (SUI) is a prevalent and costly condition which may be treated surgically or by physical therapy. The aim of this review was to systematically assess the literature and present the best available evidence for the efficacy and effectiveness of pelvic floor muscle training (PFMT) performed alone and together with adjunctive therapies (eg biofeedback, electrical stimulation, vaginal cones) for the treatment of female SUI. Methods All major electronic sources of relevant information were systematically searched to identify peer-reviewed English language abstracts or papers published between 1995 and 2005. Randomised controlled trials (RCTs) and other study designs eg non-randomised trials, cohort studies, case series, were considered for this review in order to source all the available evidence relevant to clinical practice. Studies of adult women with a urodynamic or clinical diagnosis of SUI were eligible for inclusion. Excluded were studies of women who were pregnant, immediately post-partum or with a diagnosis of mixed or urge incontinence. Studies with a PFMT protocol alone and in combination with adjunctive physical therapies were considered. Two independent reviewers assessed the eligibility of each study, its level of evidence and the methodological quality. Due to the heterogeneity of study designs, the results are presented in narrative format. Results Twenty four studies, including 17 RCTs and seven non-RCTs, met the inclusion criteria. The methodological quality of the studies varied but lower quality scores did not necessarily indicate studies from lower levels of evidence. This review found consistent evidence from a number of high quality RCTs that PFMT alone and in combination with adjunctive therapies is effective treatment for women with SUI with rates of 'cure' and 'cure/improvement' up to 73% and 97% respectively. The contribution of adjunctive therapies is unclear and there is limited evidence about treatment outcomes in primary care settings. Conclusion There is strong evidence for the efficacy of physical therapy for the treatment for SUI in women but further high quality studies are needed to evaluate the optimal treatment programs and training protocols in subgroups of women and their effectiveness in clinical practice.
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.