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Ouédraogo F, Auger LP, Moreau E, Côté O, Guerrera R, Rochette A, Kairy D. Acceptability of Telerehabilitation: Experiences and Perceptions by Individuals with Stroke and Caregivers in an Early Supported Discharge Program. Healthcare (Basel) 2024; 12:365. [PMID: 38338250 PMCID: PMC10855122 DOI: 10.3390/healthcare12030365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/25/2023] [Accepted: 12/28/2023] [Indexed: 02/12/2024] Open
Abstract
INTRODUCTION Telerehabilitation (TR) is a promising method for facilitating the delivery and access to post-stroke rehabilitation services. OBJECTIVE The aim of this study was to explore the acceptability of TR and factors influencing its adoption by individuals with stroke and caregivers. METHODS A qualitative descriptive approach was used. Six individuals with stroke and three caregivers participated in individual online interviews. An abductive thematic analysis was employed to analyze the qualitative data, using the Unified Theory of Acceptance and Use of Technology 2 (UTAUT-2) model. RESULTS Participants reported positive experiences with TR, resulting in improvements in functional abilities, such as manual dexterity, balance, and positive interactions with therapists. They found the technology easy to learn and use, facilitating engagement in TR. Participants' prior experiences with technology, along with support from caregivers and therapists, facilitated acceptance and the use of TR. The COVID-19 pandemic also motivated participants to accept TR. However, technical issues, unstable internet connections, and lack of feedback were barriers to the use of TR. CONCLUSION Despite existing obstacles, TR can be used to provide rehabilitation services for individuals with stroke. Addressing these barriers is necessary to promote the widespread and effective use of TR in the context of stroke recovery.
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Affiliation(s)
- Fatimata Ouédraogo
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC H3N 1X7, Canada; (A.R.); (D.K.)
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, QC H3S 1M9, Canada;
| | - Louis-Pierre Auger
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, QC H3S 1M9, Canada;
- Institute of Health Sciences Education, Faculty of Medicine, McGill University, Montréal, QC H3G 1A1, Canada
| | - Emmanuelle Moreau
- Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal, Centre Intégré Universitaire de Santé et Services Sociaux (CIUSSS) du Centre-Sud-de-l’Île-de-Montréal, Montréal, QC H3S 2J4, Canada; (E.M.); (O.C.); (R.G.)
| | - Odile Côté
- Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal, Centre Intégré Universitaire de Santé et Services Sociaux (CIUSSS) du Centre-Sud-de-l’Île-de-Montréal, Montréal, QC H3S 2J4, Canada; (E.M.); (O.C.); (R.G.)
| | - Rosalba Guerrera
- Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal, Centre Intégré Universitaire de Santé et Services Sociaux (CIUSSS) du Centre-Sud-de-l’Île-de-Montréal, Montréal, QC H3S 2J4, Canada; (E.M.); (O.C.); (R.G.)
| | - Annie Rochette
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC H3N 1X7, Canada; (A.R.); (D.K.)
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, QC H3S 1M9, Canada;
- Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal, Centre Intégré Universitaire de Santé et Services Sociaux (CIUSSS) du Centre-Sud-de-l’Île-de-Montréal, Montréal, QC H3S 2J4, Canada; (E.M.); (O.C.); (R.G.)
| | - Dahlia Kairy
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC H3N 1X7, Canada; (A.R.); (D.K.)
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, QC H3S 1M9, Canada;
- Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal, Centre Intégré Universitaire de Santé et Services Sociaux (CIUSSS) du Centre-Sud-de-l’Île-de-Montréal, Montréal, QC H3S 2J4, Canada; (E.M.); (O.C.); (R.G.)
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Meli AP, Russell GA, Swaminathan S, Weichselbaum L, MacMahon CA, Pernet E, Karo-Atar D, Rogers D, Rochette A, Fontes G, Mandl JN, Divangahi M, Klein OD, Gregorieff A, Stäger S, King IL. Bcl-6 expression by CD4 + T cells determines concomitant immunity and host resistance across distinct parasitic infections. Mucosal Immunol 2023; 16:801-816. [PMID: 37659724 DOI: 10.1016/j.mucimm.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 08/03/2023] [Accepted: 08/28/2023] [Indexed: 09/04/2023]
Abstract
Cluster of differentiation (CD4+) T cells consist of multiple subtypes, defined by expression of lineage-specific transcription factors, that contribute to the control of infectious diseases by providing help to immune and nonimmune target cells. In the current study, we examined the role of B cell lymphoma (Bcl)-6, a transcriptional repressor and master regulator of T follicular helper cell differentiation, in T cell-mediated host defense against intestinal and systemic parasitic infections. We demonstrate that while Bcl-6 expression by CD4+ T cells is critical for antibody-mediated protective immunity against secondary infection with the nematode Heligmosoides polygyrus bakeri, it paradoxically compromises worm expulsion during primary infection by limiting the generation of interleukin-10 (IL-10)-producing Gata3+ T helper 2 cells. Enhanced worm expulsion in the absence of Bcl-6 expressing T cells was associated with amplified intestinal goblet cell differentiation and increased generation of alternatively activated macrophages, effects that were reversed by neutralization of IL-10 signals. An increase in IL-10 production by Bcl-6-deficient CD4+ T cells was also evident in the context of systemic Leishmania donovani infection, but in contrast to Heligmosoides polygyrus bakeri infection, compromised T helper 1-mediated liver macrophage activation and increased susceptibility to this distinct parasitic challenge. Collectively, our studies suggest that host defense pathways that protect against parasite superinfection and lethal systemic protozoal infections can be engaged at the cost of compromised primary resistance to well-tolerated helminths.
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Affiliation(s)
- Alexandre P Meli
- Department of Microbiology and Immunology, Meakins-Christie Laboratories, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; McGill Interdisciplinary Initiative in Infection and Immunity, Montreal, Quebec, Canada
| | - Gabriel A Russell
- Department of Microbiology and Immunology, Meakins-Christie Laboratories, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; McGill Interdisciplinary Initiative in Infection and Immunity, Montreal, Quebec, Canada
| | | | - Laura Weichselbaum
- Department of Orofacial Sciences and Program in Craniofacial Biology, University of California, San Francisco, San Francisco, CA, USA
| | - Clara A MacMahon
- Department of Microbiology and Immunology, Meakins-Christie Laboratories, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; McGill Interdisciplinary Initiative in Infection and Immunity, Montreal, Quebec, Canada
| | - Erwan Pernet
- Research Institute of the McGill University Health Centre, Meakins-Christie Laboratories, Department of Medicine, Montreal, Quebec, Canada
| | - Danielle Karo-Atar
- Department of Microbiology and Immunology, Meakins-Christie Laboratories, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; McGill Interdisciplinary Initiative in Infection and Immunity, Montreal, Quebec, Canada
| | - Dakota Rogers
- Department of Physiology and McGill Research Centre for Complex Traits, McGill University, Montreal, Quebec, Canada
| | - Annie Rochette
- Department of Pathology and Cancer Research Program, McGill University, Montreal, Quebec, Canada
| | - Ghislaine Fontes
- Department of Microbiology and Immunology, Meakins-Christie Laboratories, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; McGill Interdisciplinary Initiative in Infection and Immunity, Montreal, Quebec, Canada
| | - Judith N Mandl
- McGill Interdisciplinary Initiative in Infection and Immunity, Montreal, Quebec, Canada; Department of Physiology and McGill Research Centre for Complex Traits, McGill University, Montreal, Quebec, Canada
| | - Maziar Divangahi
- Research Institute of the McGill University Health Centre, Meakins-Christie Laboratories, Department of Medicine, Montreal, Quebec, Canada
| | - Ophir D Klein
- Department of Orofacial Sciences and Program in Craniofacial Biology, University of California, San Francisco, San Francisco, CA, USA; Department of Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Alex Gregorieff
- Department of Pathology and Cancer Research Program, McGill University, Montreal, Quebec, Canada; McGill Regenerative Medicine Network, Montreal, Quebec, Canada
| | | | - Irah L King
- Department of Microbiology and Immunology, Meakins-Christie Laboratories, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; McGill Interdisciplinary Initiative in Infection and Immunity, Montreal, Quebec, Canada; McGill Regenerative Medicine Network, Montreal, Quebec, Canada; McGill Centre for Microbiome Research, Montreal, Quebec, Canada.
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Kim S, Rochette A, Ahmed S, Archambault PS, Auger C, Battaglini A, Freeman AR, Kehayia E, Kinsella EA, Larney E, Letts L, Nugus P, Raymond MH, Salbach NM, Sinnige D, Snider L, Swaine B, Tousignant-Laflamme Y, Thomas A. Creating synergies among education/research, practice, and policy environments to build capacity for the scholar role in occupational therapy and physiotherapy in the Canadian context. Adv Health Sci Educ Theory Pract 2023:10.1007/s10459-023-10298-9. [PMID: 38015277 DOI: 10.1007/s10459-023-10298-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 10/22/2023] [Indexed: 11/29/2023]
Abstract
Scholarly practice (SP) is considered a key competency of occupational therapy and physiotherapy. To date, the three sectors-education/research, practice, and policy/regulation-that support SP have been working relatively independently. The goals of this project were to (a) understand how representatives of the three sectors conceptualize SP; (b) define each sector's individual and collective roles in supporting SP; (c) identify factors influencing the enactment of SP and the specific needs of how best to support SP; and (d) co-develop goals and strategies to support SP across all sectors. We used interpretive description methodology. Consistent with an integrated knowledge translation approach, partners representing the three sectors across Canada recruited individuals from each sector, developed the content and questions for three focus groups, and collected and analyzed the data. Inspired by the Consolidated Framework for Implementation Research, we developed the questions for the second focus group. We analyzed the data using an inductive thematic analysis method. Thirty-nine participants from the three sectors participated. Themes related to participants' conceptualization of SP included (a) ongoing process, (b) reflective process, (c) broad concept, and (d) collective effort. Themes describing factors influencing and supporting SP were (a) recognition, (b) appropriate conceptualization, (c) social network, (d) accessibility to resources, and (e) forces outside of practitioners' effort. Goals to support SP included (a) further recognizing SP, (b) sustaining SP competency, and (c) ensuring access to information. SP requires collaborative and integrated intersectoral support and further recognition of its importance through the collaboration of multiple stakeholders.
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Affiliation(s)
- Sungha Kim
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
| | - Annie Rochette
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
| | - Sara Ahmed
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
- Clinical Epidemiology, Center for Outcome Research and Evaluation (CORE), McGill University Health Center Research Institute, Montréal, QC, Canada
| | - Philippe S Archambault
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
| | - Claudine Auger
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
- Institut universitaire sur la réadaptation en déficience physique de Montréal, Montréal, QC, Canada
| | - Alex Battaglini
- Directorate of University Teaching and Research, CISSS de Laval, Laval, QC, Canada
- l'École de Santé Publique de l'Université de Montréal, Montréal, QC, Canada
| | - Andrew R Freeman
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Québec, QC, Canada
- VITAM: Centre de Recherche en Santé Durable, Québec, QC, Canada
| | - Eva Kehayia
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
| | - Elizabeth Anne Kinsella
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
| | - Elinor Larney
- Association of Canadian Occupational Therapy Regulatory Organizations and College of Occupational Therapists of Ontario, Toronto, ON, Canada
| | - Lori Letts
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Peter Nugus
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
| | - Marie-Hélène Raymond
- Institut National d'Excellence en Santé et en Services Sociaux, Montréal, QC, Canada
| | - Nancy M Salbach
- Department of Physical Therapy, Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- The KITE Research Institute, University Health Network, Toronto, ON, Canada
| | - Diana Sinnige
- Canadian Alliance of Physiotherapy Regulators, Toronto, ON, Canada
| | - Laurie Snider
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
| | - Bonnie Swaine
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
- Institut universitaire sur la réadaptation en déficience physique de Montréal, Montréal, QC, Canada
| | - Yannick Tousignant-Laflamme
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Aliki Thomas
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada.
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada.
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada.
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Montpetit-Tourangeau K, Diaz-Arenales AS, Dyer JO, Rochette A. The Black Box of Patient Education: An Expert Consultation on Patient Education Interventions and Strategies for the Management of Subacromial Pain Syndrome. Physiother Can 2023; 75:215-232. [PMID: 37736407 PMCID: PMC10510546 DOI: 10.3138/ptc-2022-0123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 04/25/2023] [Indexed: 09/23/2023]
Abstract
Purpose To identify patient education, interventions, and strategies to optimize the management of subacromial pain syndrome (SAPS) in physical therapy, based on the experiential knowledge of patient-partners and caregivers involved in the rehabilitation of this condition. Method Using a semi-deductive approach building on the evidence extracted from the literature, an expert consultation using focus groups was conducted. The experts were physical therapists (n = 5) and an occupational therapist with extensive clinical experience, as well as a patient-partner. Analysis followed the Framework method. Results Two main themes emerged: (1) interventions directly related to patient education, consisting of nine sub-themes, including symptom self-management and pain phenomenon, and (2) patient education strategies to broadly frame the interventions, consisting of 10 sub-themes, including educational materials and clinical teaching approaches. Conclusion The consultation confirmed and expanded the knowledge from the literature by adding knowledge that emerged from the experts' practical experience. It resulted in the development of preliminary statements on structured patient education interventions and management strategies for SAPS. These emerging statements are, to our knowledge, the first to inform patient education specifically as it relates to the management of SAPS taking into account psychosocial and contextual factors.
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Affiliation(s)
- Katherine Montpetit-Tourangeau
- From the:
School of Rehabilitation, University of Montreal, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, Canada
| | | | - Joseph-Omer Dyer
- From the:
School of Rehabilitation, University of Montreal, Montreal, Canada
- Interdisciplinary Research Group in Cognition and Professional Reasoning, Center for Applied Pedagogy in Health Sciences, University of Montreal, Montreal, Canada
| | - Annie Rochette
- From the:
School of Rehabilitation, University of Montreal, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, Canada
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Thomas A, Amari F, Mylopoulos M, Vachon B, Menon A, Rochette A. Being and Becoming an Evidence-Based Practitioner: Occupational Therapists' Journey Toward Expertise. Am J Occup Ther 2023; 77:7705205030. [PMID: 37801556 DOI: 10.5014/ajot.2023.050193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/08/2023] Open
Abstract
IMPORTANCE Despite mounting evidence for the management of various health care conditions, the uptake of scientific evidence in occupational therapy is often suboptimal. Although positive attitudes and self-efficacy are key to evidence-based practices (EBPs), how one becomes an evidence-based practitioner, and how expertise in EBP manifests in practice, remains unclear. OBJECTIVE To describe how expert evidence-based practitioners conceptualize and enact their expertise in stroke rehabilitation. DESIGN Qualitative interpretive descriptive study using in-depth semistructured interviews with eight occupational therapists identified as expert evidence-based practitioners in a previous study. Transcripts were analyzed using an inductive thematic content analysis, and emergent themes were identified. SETTINGS Rehabilitation settings across Canada. RESULTS Six overarching themes emerged: (1) relying on personal attributes to engage in practice improvement, (2) acting on factors that motivate and trigger EBP, (3) achieving better outcomes because of engagement in EBP, (4) using an adaptive decision-making process, (5) participating in professional activities that contribute to practice improvement, and (6) working in a practice area with a large body of evidence. CONCLUSIONS AND RELEVANCE Expertise in stroke rehabilitation EBP appears to be a function of several personal attributes and habits of mind in addition to being influenced by a commitment to client-centered practice. Expertise requires a combination of deliberate effort and motivation to improve client outcomes, always in a context conducive to reflection, adaptation, and openness to innovation. Experts who model these traits and articulate the processes used to develop their expertise can be viewed as promising educational and continuing professional development resources. What This Article Adds: Expert evidence-based occupational therapists develop their expertise in this domain through commitment to client-centered practice, efforts toward honing this aspect of practice, and a willingness to innovate and adapt to challenging situations.
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Affiliation(s)
- Aliki Thomas
- Aliki Thomas, PhD, OT(c), erg, is Associate Professor, School of Physical and Occupational Therapy, and Associate Member, Institute of Health Sciences Education, McGill University, and Researcher, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Quebec, Canada;
| | - Fatima Amari
- Fatima Amari, MScM, OT, is Research Coordinator, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Maria Mylopoulos
- Maria Mylopoulos, PhD, is Professor, Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Brigitte Vachon
- Brigitte Vachon, PhD, OT(c), erg, is Associate Professor, School of Rehabilitation, Faculté de Médecine, Université de Montréal, and Scientist, Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Quebec, Canada
| | - Anita Menon
- Anita Menon, PhD, OT(c), erg, is Assistant Professor (professional), School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Annie Rochette
- Annie Rochette, PhD, OT(c), erg, is Professor, School of Rehabilitation, Université de Montréal, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, and Scientist, Institut Universitaire Sur la Réadaptation en Défience Physique de Montréal, Montreal, Quebec, Canada
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Thomas A, Roberge-Dao J, Iqbal MZ, Salbach NM, Letts LJ, Polatajko HJ, Rappolt S, Debigaré R, Ahmed S, Bussières A, Paterson M, Rochette A. Developing multisectoral strategies to promote evidence-based practice in rehabilitation: findings from an end-of-grant knowledge translation symposium. Disabil Rehabil 2023:1-12. [PMID: 37399539 DOI: 10.1080/09638288.2023.2227565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 05/14/2023] [Accepted: 06/15/2023] [Indexed: 07/05/2023]
Abstract
PURPOSE Following a longitudinal study to understand how evidence-based practice evolves during the initial years of occupational therapy (OT) and physiotherapy (PT) practice, we held an end-of-grant symposium with representatives from education, practice, research, and policy. The objectives were to: (1) elicit feedback on the implications of the study results; and (2) co-develop a list of actionable recommendations for each sector. METHODS Qualitative participatory approach. The symposium was held over two half days and consisted of a presentation of study findings, a discussion on the implications of the research for each sector and future recommendations. Discussions were audio recorded, transcribed verbatim and analyzed using qualitative thematic analysis. RESULTS The themes related to implications of the longitudinal study included: (1) A need to rethink what evidence-based practice (EBP) really is; (2) How to practice EBP; and (3) The continuing challenge of measuring EBP. The co-development of actionable recommendations resulted in nine strategies. CONCLUSIONS This study highlighted how we may collectively promote EBP competencies in future OTs and PTs. We generated sector-specific avenues that may be pursued to promote EBP and argued for the importance of pooling efforts from the four sectors so that we may achieve the intended ethos of EBP.IMPLICATIONS FOR REHABILITATIONThere is a need to revisit the definition of evidence-based practice (EBP) and the traditional 3-circle model in rehabilitation to include a broader conceptualization of what constitutes evidence.We recommend using EBP measures as tools for self-reflection and professional development that can support practitioners to be reflective and accountable evidence-based practitioners.Optimal promotion of EBP competencies in occupational therapists and physiotherapists should rest upon collaborative efforts from the education, practice, research, and policy sectors.
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Affiliation(s)
- Aliki Thomas
- School of Physical and Occupational Therapy and Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
| | - Jacqueline Roberge-Dao
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Muhammad Zafar Iqbal
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Research Department, Acuity Insights, Toronto, Canada
| | - Nancy M Salbach
- Department of Physical Therapy, Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Lori Jean Letts
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | - Helene J Polatajko
- Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Susan Rappolt
- Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Richard Debigaré
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec, Canada
| | - Sara Ahmed
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Center for Outcomes Research and Evaluation (CORE), Research Institute of McGill University, Montreal, Canada
| | - André Bussières
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Département Chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Margo Paterson
- School of rehabilitation Therapy, Queen's University, Kingston, Canada
| | - Annie Rochette
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
- School of Rehabilitation, Université de Montréal, Montreal, Canada
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Thomas A, St-Onge C, Renaud JS, George C, Iqbal MZ, Brousseau M, Dyer JO, Gallagher F, Lacasse M, Ledoux I, Vachon B, Rochette A. Measuring Health Care Work-Related Contextual Factors: Development of the McGill Context Tool. J Contin Educ Health Prof 2023; 44:18-27. [PMID: 37341570 DOI: 10.1097/ceh.0000000000000514] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
INTRODUCTION Contextual factors can influence healthcare professionals' (HCPs) competencies, yet there is a scarcity of research on how to optimally measure these factors. The aim of this study was to develop and validate a comprehensive tool for HCPs to document the contextual factors likely to influence the maintenance, development, and deployment of professional competencies. METHODS We used DeVellis' 8-step process for scale development and Messick's unified theory of validity to inform the development and validation of the context tool. Building on results from a scoping review, we generated an item pool of contextual factors articulated around five themes: Leadership and Agency, Values, Policies, Supports, and Demands. A first version of the tool was pilot tested with 127 HCPs and analyzed using the classical test theory. A second version was tested on a larger sample (n = 581) and analyzed using the Rasch rating scale model. RESULTS First version of the tool: we piloted 117 items that were grouped as per the themes related to contextual factors and rated on a 5-point Likert scale. Cronbach alpha for the set of 12 retained items per scale ranged from 0.75 to 0.94. Second version of the tool included 60 items: Rasch analysis showed that four of the five scales (ie, Leadership and Agency, Values, Policies, Supports) can be used as unidimensional scales, whereas the fifth scale (Demands) had to be split into two unidimensional scales (Demands and Overdemands). DISCUSSION Validity evidence documented for content and internal structure is encouraging and supports the use of the McGill context tool. Future research will provide additional validity evidence and cross-cultural translation.
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Affiliation(s)
- Aliki Thomas
- Aliki Thomas, Associate Professor, School of Physical and Occupational Therapy, Research Scientist, Institute of Health Sciences Education, McGill University. Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada. Christina St-Onge, Professor, Department of Medicine and Center for Health Sciences Education, Université de Sherbrooke. Paul Grand'Maison de la Société des Médecins de l'Université de Sherbrooke-Research Chair in Medical Education, Sherbrooke, Quebec, Canada. Jean-Sébastien Renaud, Professor, Department of Family and Emergency Medicine, VITAM Research Center, Université Laval, Quebec, Quebec, Canada. Catherine George, School of Physical and Occupational Therapy, Research Scientist, McGill University, Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada
- Muhammad Zafar Iqbal, Post-Doctoral Fellow, School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Centre for Interdisciplinary Research in Rehabilitation Montreal, Quebec, Canada.Martine Brousseau, Professor, Department of Occupational Therapy, Université du Québec à Trois Rivieres, Trois-Rivières, Quebec, Canada. Joseph-Omer Dyer, Associate Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal. Groupe interdisciplinaire de recherche sur la cognition et le raisonnement professionnel, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada. Frances Gallagher, Professor, Faculty of Medecine and Health Sciences. School of Nursing, Université de Sherbrooke, Research Group in Pursuit of Validity, Centre de Recherche Du CHUS, Sherbrooke, Quebec, Canada. Miriam Lacasse, Professor, Département de Médecine Familiale et de Médecine D'urgence, Faculté de Médecine, Université Laval, Quebec, Quebec, Canada. Isabelle Ledoux, Associate Professor, Faculty of Medicine and Health Sciences, School of Nursing, Université de Sherbrooke, Sherbrooke, Quebec, Canada. Brigitte Vachon, Associate Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal. Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Quebec, Canada. Annie Rochette, Professor, Occupational Therapy Program, School of Rehabilitation, Université de Montréal. Centre for Interdisciplinary Research in Rehabilitation, Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Montreal, Quebec, Canada
| | - Christina St-Onge
- Aliki Thomas, Associate Professor, School of Physical and Occupational Therapy, Research Scientist, Institute of Health Sciences Education, McGill University. Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada. Christina St-Onge, Professor, Department of Medicine and Center for Health Sciences Education, Université de Sherbrooke. Paul Grand'Maison de la Société des Médecins de l'Université de Sherbrooke-Research Chair in Medical Education, Sherbrooke, Quebec, Canada. Jean-Sébastien Renaud, Professor, Department of Family and Emergency Medicine, VITAM Research Center, Université Laval, Quebec, Quebec, Canada. Catherine George, School of Physical and Occupational Therapy, Research Scientist, McGill University, Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada
- Muhammad Zafar Iqbal, Post-Doctoral Fellow, School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Centre for Interdisciplinary Research in Rehabilitation Montreal, Quebec, Canada.Martine Brousseau, Professor, Department of Occupational Therapy, Université du Québec à Trois Rivieres, Trois-Rivières, Quebec, Canada. Joseph-Omer Dyer, Associate Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal. Groupe interdisciplinaire de recherche sur la cognition et le raisonnement professionnel, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada. Frances Gallagher, Professor, Faculty of Medecine and Health Sciences. School of Nursing, Université de Sherbrooke, Research Group in Pursuit of Validity, Centre de Recherche Du CHUS, Sherbrooke, Quebec, Canada. Miriam Lacasse, Professor, Département de Médecine Familiale et de Médecine D'urgence, Faculté de Médecine, Université Laval, Quebec, Quebec, Canada. Isabelle Ledoux, Associate Professor, Faculty of Medicine and Health Sciences, School of Nursing, Université de Sherbrooke, Sherbrooke, Quebec, Canada. Brigitte Vachon, Associate Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal. Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Quebec, Canada. Annie Rochette, Professor, Occupational Therapy Program, School of Rehabilitation, Université de Montréal. Centre for Interdisciplinary Research in Rehabilitation, Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Montreal, Quebec, Canada
| | - Jean-Sébastien Renaud
- Aliki Thomas, Associate Professor, School of Physical and Occupational Therapy, Research Scientist, Institute of Health Sciences Education, McGill University. Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada. Christina St-Onge, Professor, Department of Medicine and Center for Health Sciences Education, Université de Sherbrooke. Paul Grand'Maison de la Société des Médecins de l'Université de Sherbrooke-Research Chair in Medical Education, Sherbrooke, Quebec, Canada. Jean-Sébastien Renaud, Professor, Department of Family and Emergency Medicine, VITAM Research Center, Université Laval, Quebec, Quebec, Canada. Catherine George, School of Physical and Occupational Therapy, Research Scientist, McGill University, Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada
- Muhammad Zafar Iqbal, Post-Doctoral Fellow, School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Centre for Interdisciplinary Research in Rehabilitation Montreal, Quebec, Canada.Martine Brousseau, Professor, Department of Occupational Therapy, Université du Québec à Trois Rivieres, Trois-Rivières, Quebec, Canada. Joseph-Omer Dyer, Associate Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal. Groupe interdisciplinaire de recherche sur la cognition et le raisonnement professionnel, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada. Frances Gallagher, Professor, Faculty of Medecine and Health Sciences. School of Nursing, Université de Sherbrooke, Research Group in Pursuit of Validity, Centre de Recherche Du CHUS, Sherbrooke, Quebec, Canada. Miriam Lacasse, Professor, Département de Médecine Familiale et de Médecine D'urgence, Faculté de Médecine, Université Laval, Quebec, Quebec, Canada. Isabelle Ledoux, Associate Professor, Faculty of Medicine and Health Sciences, School of Nursing, Université de Sherbrooke, Sherbrooke, Quebec, Canada. Brigitte Vachon, Associate Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal. Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Quebec, Canada. Annie Rochette, Professor, Occupational Therapy Program, School of Rehabilitation, Université de Montréal. Centre for Interdisciplinary Research in Rehabilitation, Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Montreal, Quebec, Canada
| | - Catherine George
- Aliki Thomas, Associate Professor, School of Physical and Occupational Therapy, Research Scientist, Institute of Health Sciences Education, McGill University. Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada. Christina St-Onge, Professor, Department of Medicine and Center for Health Sciences Education, Université de Sherbrooke. Paul Grand'Maison de la Société des Médecins de l'Université de Sherbrooke-Research Chair in Medical Education, Sherbrooke, Quebec, Canada. Jean-Sébastien Renaud, Professor, Department of Family and Emergency Medicine, VITAM Research Center, Université Laval, Quebec, Quebec, Canada. Catherine George, School of Physical and Occupational Therapy, Research Scientist, McGill University, Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada
- Muhammad Zafar Iqbal, Post-Doctoral Fellow, School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Centre for Interdisciplinary Research in Rehabilitation Montreal, Quebec, Canada.Martine Brousseau, Professor, Department of Occupational Therapy, Université du Québec à Trois Rivieres, Trois-Rivières, Quebec, Canada. Joseph-Omer Dyer, Associate Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal. Groupe interdisciplinaire de recherche sur la cognition et le raisonnement professionnel, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada. Frances Gallagher, Professor, Faculty of Medecine and Health Sciences. School of Nursing, Université de Sherbrooke, Research Group in Pursuit of Validity, Centre de Recherche Du CHUS, Sherbrooke, Quebec, Canada. Miriam Lacasse, Professor, Département de Médecine Familiale et de Médecine D'urgence, Faculté de Médecine, Université Laval, Quebec, Quebec, Canada. Isabelle Ledoux, Associate Professor, Faculty of Medicine and Health Sciences, School of Nursing, Université de Sherbrooke, Sherbrooke, Quebec, Canada. Brigitte Vachon, Associate Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal. Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Quebec, Canada. Annie Rochette, Professor, Occupational Therapy Program, School of Rehabilitation, Université de Montréal. Centre for Interdisciplinary Research in Rehabilitation, Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Montreal, Quebec, Canada
| | - Muhammad Zafar Iqbal
- Aliki Thomas, Associate Professor, School of Physical and Occupational Therapy, Research Scientist, Institute of Health Sciences Education, McGill University. Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada. Christina St-Onge, Professor, Department of Medicine and Center for Health Sciences Education, Université de Sherbrooke. Paul Grand'Maison de la Société des Médecins de l'Université de Sherbrooke-Research Chair in Medical Education, Sherbrooke, Quebec, Canada. Jean-Sébastien Renaud, Professor, Department of Family and Emergency Medicine, VITAM Research Center, Université Laval, Quebec, Quebec, Canada. Catherine George, School of Physical and Occupational Therapy, Research Scientist, McGill University, Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada
- Muhammad Zafar Iqbal, Post-Doctoral Fellow, School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Centre for Interdisciplinary Research in Rehabilitation Montreal, Quebec, Canada.Martine Brousseau, Professor, Department of Occupational Therapy, Université du Québec à Trois Rivieres, Trois-Rivières, Quebec, Canada. Joseph-Omer Dyer, Associate Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal. Groupe interdisciplinaire de recherche sur la cognition et le raisonnement professionnel, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada. Frances Gallagher, Professor, Faculty of Medecine and Health Sciences. School of Nursing, Université de Sherbrooke, Research Group in Pursuit of Validity, Centre de Recherche Du CHUS, Sherbrooke, Quebec, Canada. Miriam Lacasse, Professor, Département de Médecine Familiale et de Médecine D'urgence, Faculté de Médecine, Université Laval, Quebec, Quebec, Canada. Isabelle Ledoux, Associate Professor, Faculty of Medicine and Health Sciences, School of Nursing, Université de Sherbrooke, Sherbrooke, Quebec, Canada. Brigitte Vachon, Associate Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal. Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Quebec, Canada. Annie Rochette, Professor, Occupational Therapy Program, School of Rehabilitation, Université de Montréal. Centre for Interdisciplinary Research in Rehabilitation, Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Montreal, Quebec, Canada
| | - Martine Brousseau
- Aliki Thomas, Associate Professor, School of Physical and Occupational Therapy, Research Scientist, Institute of Health Sciences Education, McGill University. Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada. Christina St-Onge, Professor, Department of Medicine and Center for Health Sciences Education, Université de Sherbrooke. Paul Grand'Maison de la Société des Médecins de l'Université de Sherbrooke-Research Chair in Medical Education, Sherbrooke, Quebec, Canada. Jean-Sébastien Renaud, Professor, Department of Family and Emergency Medicine, VITAM Research Center, Université Laval, Quebec, Quebec, Canada. Catherine George, School of Physical and Occupational Therapy, Research Scientist, McGill University, Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada
- Muhammad Zafar Iqbal, Post-Doctoral Fellow, School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Centre for Interdisciplinary Research in Rehabilitation Montreal, Quebec, Canada.Martine Brousseau, Professor, Department of Occupational Therapy, Université du Québec à Trois Rivieres, Trois-Rivières, Quebec, Canada. Joseph-Omer Dyer, Associate Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal. Groupe interdisciplinaire de recherche sur la cognition et le raisonnement professionnel, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada. Frances Gallagher, Professor, Faculty of Medecine and Health Sciences. School of Nursing, Université de Sherbrooke, Research Group in Pursuit of Validity, Centre de Recherche Du CHUS, Sherbrooke, Quebec, Canada. Miriam Lacasse, Professor, Département de Médecine Familiale et de Médecine D'urgence, Faculté de Médecine, Université Laval, Quebec, Quebec, Canada. Isabelle Ledoux, Associate Professor, Faculty of Medicine and Health Sciences, School of Nursing, Université de Sherbrooke, Sherbrooke, Quebec, Canada. Brigitte Vachon, Associate Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal. Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Quebec, Canada. Annie Rochette, Professor, Occupational Therapy Program, School of Rehabilitation, Université de Montréal. Centre for Interdisciplinary Research in Rehabilitation, Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Montreal, Quebec, Canada
| | - Joseph-Omer Dyer
- Aliki Thomas, Associate Professor, School of Physical and Occupational Therapy, Research Scientist, Institute of Health Sciences Education, McGill University. Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada. Christina St-Onge, Professor, Department of Medicine and Center for Health Sciences Education, Université de Sherbrooke. Paul Grand'Maison de la Société des Médecins de l'Université de Sherbrooke-Research Chair in Medical Education, Sherbrooke, Quebec, Canada. Jean-Sébastien Renaud, Professor, Department of Family and Emergency Medicine, VITAM Research Center, Université Laval, Quebec, Quebec, Canada. Catherine George, School of Physical and Occupational Therapy, Research Scientist, McGill University, Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada
- Muhammad Zafar Iqbal, Post-Doctoral Fellow, School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Centre for Interdisciplinary Research in Rehabilitation Montreal, Quebec, Canada.Martine Brousseau, Professor, Department of Occupational Therapy, Université du Québec à Trois Rivieres, Trois-Rivières, Quebec, Canada. Joseph-Omer Dyer, Associate Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal. Groupe interdisciplinaire de recherche sur la cognition et le raisonnement professionnel, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada. Frances Gallagher, Professor, Faculty of Medecine and Health Sciences. School of Nursing, Université de Sherbrooke, Research Group in Pursuit of Validity, Centre de Recherche Du CHUS, Sherbrooke, Quebec, Canada. Miriam Lacasse, Professor, Département de Médecine Familiale et de Médecine D'urgence, Faculté de Médecine, Université Laval, Quebec, Quebec, Canada. Isabelle Ledoux, Associate Professor, Faculty of Medicine and Health Sciences, School of Nursing, Université de Sherbrooke, Sherbrooke, Quebec, Canada. Brigitte Vachon, Associate Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal. Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Quebec, Canada. Annie Rochette, Professor, Occupational Therapy Program, School of Rehabilitation, Université de Montréal. Centre for Interdisciplinary Research in Rehabilitation, Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Montreal, Quebec, Canada
| | - Frances Gallagher
- Aliki Thomas, Associate Professor, School of Physical and Occupational Therapy, Research Scientist, Institute of Health Sciences Education, McGill University. Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada. Christina St-Onge, Professor, Department of Medicine and Center for Health Sciences Education, Université de Sherbrooke. Paul Grand'Maison de la Société des Médecins de l'Université de Sherbrooke-Research Chair in Medical Education, Sherbrooke, Quebec, Canada. Jean-Sébastien Renaud, Professor, Department of Family and Emergency Medicine, VITAM Research Center, Université Laval, Quebec, Quebec, Canada. Catherine George, School of Physical and Occupational Therapy, Research Scientist, McGill University, Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada
- Muhammad Zafar Iqbal, Post-Doctoral Fellow, School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Centre for Interdisciplinary Research in Rehabilitation Montreal, Quebec, Canada.Martine Brousseau, Professor, Department of Occupational Therapy, Université du Québec à Trois Rivieres, Trois-Rivières, Quebec, Canada. Joseph-Omer Dyer, Associate Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal. Groupe interdisciplinaire de recherche sur la cognition et le raisonnement professionnel, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada. Frances Gallagher, Professor, Faculty of Medecine and Health Sciences. School of Nursing, Université de Sherbrooke, Research Group in Pursuit of Validity, Centre de Recherche Du CHUS, Sherbrooke, Quebec, Canada. Miriam Lacasse, Professor, Département de Médecine Familiale et de Médecine D'urgence, Faculté de Médecine, Université Laval, Quebec, Quebec, Canada. Isabelle Ledoux, Associate Professor, Faculty of Medicine and Health Sciences, School of Nursing, Université de Sherbrooke, Sherbrooke, Quebec, Canada. Brigitte Vachon, Associate Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal. Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Quebec, Canada. Annie Rochette, Professor, Occupational Therapy Program, School of Rehabilitation, Université de Montréal. Centre for Interdisciplinary Research in Rehabilitation, Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Montreal, Quebec, Canada
| | - Miriam Lacasse
- Aliki Thomas, Associate Professor, School of Physical and Occupational Therapy, Research Scientist, Institute of Health Sciences Education, McGill University. Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada. Christina St-Onge, Professor, Department of Medicine and Center for Health Sciences Education, Université de Sherbrooke. Paul Grand'Maison de la Société des Médecins de l'Université de Sherbrooke-Research Chair in Medical Education, Sherbrooke, Quebec, Canada. Jean-Sébastien Renaud, Professor, Department of Family and Emergency Medicine, VITAM Research Center, Université Laval, Quebec, Quebec, Canada. Catherine George, School of Physical and Occupational Therapy, Research Scientist, McGill University, Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada
- Muhammad Zafar Iqbal, Post-Doctoral Fellow, School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Centre for Interdisciplinary Research in Rehabilitation Montreal, Quebec, Canada.Martine Brousseau, Professor, Department of Occupational Therapy, Université du Québec à Trois Rivieres, Trois-Rivières, Quebec, Canada. Joseph-Omer Dyer, Associate Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal. Groupe interdisciplinaire de recherche sur la cognition et le raisonnement professionnel, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada. Frances Gallagher, Professor, Faculty of Medecine and Health Sciences. School of Nursing, Université de Sherbrooke, Research Group in Pursuit of Validity, Centre de Recherche Du CHUS, Sherbrooke, Quebec, Canada. Miriam Lacasse, Professor, Département de Médecine Familiale et de Médecine D'urgence, Faculté de Médecine, Université Laval, Quebec, Quebec, Canada. Isabelle Ledoux, Associate Professor, Faculty of Medicine and Health Sciences, School of Nursing, Université de Sherbrooke, Sherbrooke, Quebec, Canada. Brigitte Vachon, Associate Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal. Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Quebec, Canada. Annie Rochette, Professor, Occupational Therapy Program, School of Rehabilitation, Université de Montréal. Centre for Interdisciplinary Research in Rehabilitation, Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Montreal, Quebec, Canada
| | - Isabelle Ledoux
- Aliki Thomas, Associate Professor, School of Physical and Occupational Therapy, Research Scientist, Institute of Health Sciences Education, McGill University. Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada. Christina St-Onge, Professor, Department of Medicine and Center for Health Sciences Education, Université de Sherbrooke. Paul Grand'Maison de la Société des Médecins de l'Université de Sherbrooke-Research Chair in Medical Education, Sherbrooke, Quebec, Canada. Jean-Sébastien Renaud, Professor, Department of Family and Emergency Medicine, VITAM Research Center, Université Laval, Quebec, Quebec, Canada. Catherine George, School of Physical and Occupational Therapy, Research Scientist, McGill University, Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada
- Muhammad Zafar Iqbal, Post-Doctoral Fellow, School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Centre for Interdisciplinary Research in Rehabilitation Montreal, Quebec, Canada.Martine Brousseau, Professor, Department of Occupational Therapy, Université du Québec à Trois Rivieres, Trois-Rivières, Quebec, Canada. Joseph-Omer Dyer, Associate Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal. Groupe interdisciplinaire de recherche sur la cognition et le raisonnement professionnel, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada. Frances Gallagher, Professor, Faculty of Medecine and Health Sciences. School of Nursing, Université de Sherbrooke, Research Group in Pursuit of Validity, Centre de Recherche Du CHUS, Sherbrooke, Quebec, Canada. Miriam Lacasse, Professor, Département de Médecine Familiale et de Médecine D'urgence, Faculté de Médecine, Université Laval, Quebec, Quebec, Canada. Isabelle Ledoux, Associate Professor, Faculty of Medicine and Health Sciences, School of Nursing, Université de Sherbrooke, Sherbrooke, Quebec, Canada. Brigitte Vachon, Associate Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal. Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Quebec, Canada. Annie Rochette, Professor, Occupational Therapy Program, School of Rehabilitation, Université de Montréal. Centre for Interdisciplinary Research in Rehabilitation, Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Montreal, Quebec, Canada
| | - Brigitte Vachon
- Aliki Thomas, Associate Professor, School of Physical and Occupational Therapy, Research Scientist, Institute of Health Sciences Education, McGill University. Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada. Christina St-Onge, Professor, Department of Medicine and Center for Health Sciences Education, Université de Sherbrooke. Paul Grand'Maison de la Société des Médecins de l'Université de Sherbrooke-Research Chair in Medical Education, Sherbrooke, Quebec, Canada. Jean-Sébastien Renaud, Professor, Department of Family and Emergency Medicine, VITAM Research Center, Université Laval, Quebec, Quebec, Canada. Catherine George, School of Physical and Occupational Therapy, Research Scientist, McGill University, Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada
- Muhammad Zafar Iqbal, Post-Doctoral Fellow, School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Centre for Interdisciplinary Research in Rehabilitation Montreal, Quebec, Canada.Martine Brousseau, Professor, Department of Occupational Therapy, Université du Québec à Trois Rivieres, Trois-Rivières, Quebec, Canada. Joseph-Omer Dyer, Associate Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal. Groupe interdisciplinaire de recherche sur la cognition et le raisonnement professionnel, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada. Frances Gallagher, Professor, Faculty of Medecine and Health Sciences. School of Nursing, Université de Sherbrooke, Research Group in Pursuit of Validity, Centre de Recherche Du CHUS, Sherbrooke, Quebec, Canada. Miriam Lacasse, Professor, Département de Médecine Familiale et de Médecine D'urgence, Faculté de Médecine, Université Laval, Quebec, Quebec, Canada. Isabelle Ledoux, Associate Professor, Faculty of Medicine and Health Sciences, School of Nursing, Université de Sherbrooke, Sherbrooke, Quebec, Canada. Brigitte Vachon, Associate Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal. Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Quebec, Canada. Annie Rochette, Professor, Occupational Therapy Program, School of Rehabilitation, Université de Montréal. Centre for Interdisciplinary Research in Rehabilitation, Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Montreal, Quebec, Canada
| | - Annie Rochette
- Aliki Thomas, Associate Professor, School of Physical and Occupational Therapy, Research Scientist, Institute of Health Sciences Education, McGill University. Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada. Christina St-Onge, Professor, Department of Medicine and Center for Health Sciences Education, Université de Sherbrooke. Paul Grand'Maison de la Société des Médecins de l'Université de Sherbrooke-Research Chair in Medical Education, Sherbrooke, Quebec, Canada. Jean-Sébastien Renaud, Professor, Department of Family and Emergency Medicine, VITAM Research Center, Université Laval, Quebec, Quebec, Canada. Catherine George, School of Physical and Occupational Therapy, Research Scientist, McGill University, Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada
- Muhammad Zafar Iqbal, Post-Doctoral Fellow, School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Centre for Interdisciplinary Research in Rehabilitation Montreal, Quebec, Canada.Martine Brousseau, Professor, Department of Occupational Therapy, Université du Québec à Trois Rivieres, Trois-Rivières, Quebec, Canada. Joseph-Omer Dyer, Associate Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal. Groupe interdisciplinaire de recherche sur la cognition et le raisonnement professionnel, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada. Frances Gallagher, Professor, Faculty of Medecine and Health Sciences. School of Nursing, Université de Sherbrooke, Research Group in Pursuit of Validity, Centre de Recherche Du CHUS, Sherbrooke, Quebec, Canada. Miriam Lacasse, Professor, Département de Médecine Familiale et de Médecine D'urgence, Faculté de Médecine, Université Laval, Quebec, Quebec, Canada. Isabelle Ledoux, Associate Professor, Faculty of Medicine and Health Sciences, School of Nursing, Université de Sherbrooke, Sherbrooke, Quebec, Canada. Brigitte Vachon, Associate Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal. Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Quebec, Canada. Annie Rochette, Professor, Occupational Therapy Program, School of Rehabilitation, Université de Montréal. Centre for Interdisciplinary Research in Rehabilitation, Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Montreal, Quebec, Canada
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8
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Beaudry L, Rochette A, Fortin S. Adapting Dance to Complex Clinical Contexts: A Methodology Model. J Dance Med Sci 2023:1089313X231177158. [PMID: 37278209 DOI: 10.1177/1089313x231177158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study aimed to document the process of adapting a dance intervention in a complex clinical setting, in order to propose a methodology that could inspire the development of other interventions in specific clinical contexts. While the content of health-related dance interventions is still relatively undocumented in the literature, the processes of adapting dance to specific situations are even less so, and rarely seem to be based on theoretical or practical guidelines. Yet the description of these processes could guide the adaptation of other interventions. The adaptation methodology described in this article is part of an embedded single-case study, where the case unit was the adaptation process of a dance group intervention and the subunits of analysis were the intervention's clinical and theoretical premises, content, and pedagogy. Participants were rehabilitation therapists (n = 21), patients (n = 6), relatives (n = 4), and rehabilitation assistants (n = 4). Data were collected through various techniques (focus groups, situational observation, pilot dance sessions, interviews, critical incidents, research journals, template for intervention description, and replication/TIDieR checklist, and video recordings) to allow an iterative adaptation process. Inductive qualitative analysis revealed that the adaptations were made prior to and throughout the intervention, taking into account relevant scientific and disciplinary knowledge, as well as the different actors' implicit, and explicit experiences. The intervention pedagogy focused on adapting the dance content to meet the participants' needs while inviting them to self-adapt this content. The resulting methodology model includes 4 stages: preliminary design, validation with rehabilitation therapists, specific tailoring, and ongoing tailoring. Optimizing the adaptation of dance and ensuring its complementarity within a complex clinical context requires collaboration with the different disciplinary clinicians in order to offer synergistic coherence and ensure dance's contribution to therapeutic objectives.
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Affiliation(s)
- Lucie Beaudry
- Department of Dance, Université du Québec à Montréal, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation (CRIR) of Greater Montreal, Montreal, Canada
| | - Annie Rochette
- Centre for Interdisciplinary Research in Rehabilitation (CRIR) of Greater Montreal, Montreal, Canada
- School of Rehabilitation, Université de Montréal, Montreal, Canada
| | - Sylvie Fortin
- Department of Dance, Université du Québec à Montréal, Montreal, Canada
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9
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Auger LP, Filiatrault J, Allegue DR, Vachon B, Thomas A, Morales E, Rochette A. Sexual Rehabilitation After a Stroke: A Multi-site Qualitative Study About Influencing Factors and Strategies to Improve Services. Sex Disabil 2023; 41:1-27. [PMID: 37362801 PMCID: PMC10206562 DOI: 10.1007/s11195-023-09795-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2023] [Indexed: 06/28/2023]
Abstract
This study aimed to better understand the factors influencing the provision of sexuality-related post-stroke rehabilitation services by clinicians on different sites and to explore strategies to improve post-stroke rehabilitation services with stakeholders. A qualitative study with co-design methods was conducted with 20 clinicians from five post-stroke rehabilitation centers in Canada, 1 manager and 1 patient-partner. Participants either took part in a focus group or in sessions of an adapted version of the LEGO Serious Play method to explore influencing factors and strategies of improvement in relation to post-stroke sexual rehabilitation services. Thematic analysis was conducted semi-deductively using the Theoretical Domains Framework (TDF), the Capability, Opportunity, Motivation and Behaviour (COM-B) system and the Behaviour Change Wheel (BCW). A total of twenty factors pertaining either to the categories of Capability (n = 8; e.g., Sexual rehabilitation procedural knowledge), Motivation (n = 4; e.g., Professional boundaries) or Opportunity (n = 8; e.g., Workload) were perceived as influencing provision of sexual rehabilitation services by participants. A theoretical model was conceptualized. Strategies (n = 10) were categorized in concordance with the BCW as Training (n = 1), Enablement (n = 5) or Environmental restructuring (n = 4). This study showed that factors influencing provision of post-stroke rehabilitation services were numerous and interrelated, and that various strategies aiming either clinicians or the rehabilitation environment would be relevant to improve services. This study will help guide the design and implementation of future interventions studies aiming at improving post-stroke sexual rehabilitation services.
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Affiliation(s)
- Louis-Pierre Auger
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montreal, QC Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363 Chem. Hudson, Montreal, QC H3S 1M9 Canada
| | - Johanne Filiatrault
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montreal, QC Canada
- Montreal Geriatric University Institute Research Center, Montreal, QC Canada
| | - Dorra Rakia Allegue
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363 Chem. Hudson, Montreal, QC H3S 1M9 Canada
- Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, McGill University, Montreal, QC Canada
| | - Brigitte Vachon
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montreal, QC Canada
- Montreal University Institute of Mental Health, Montreal, QC Canada
| | - Aliki Thomas
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363 Chem. Hudson, Montreal, QC H3S 1M9 Canada
- Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, McGill University, Montreal, QC Canada
| | - Ernesto Morales
- Department of Rehabilitation, Université Laval, Quebec City, QC Canada
- Interdisciplinary Research Centre in Rehabilitation and Social Inclusion (CIRRIS), Quebec City, QC Canada
| | - Annie Rochette
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montreal, QC Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363 Chem. Hudson, Montreal, QC H3S 1M9 Canada
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Rochette A, Thomas A, Salbach NM, Vachon B, Menon A, Poissant L, Boutin M, Grad R, Pluye P. Expected Health Benefits as the Ultimate Outcome of Information Available on Stroke Engine, a Knowledge Translation Stroke Rehabilitation Website: Web-Based Survey. JMIR Rehabil Assist Technol 2023; 10:e44715. [PMID: 37155228 DOI: 10.2196/44715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/15/2023] [Accepted: 03/30/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Electronic knowledge resources are readily available and typically target different audiences, including health professionals and the public, that is, those with lived experience and their relatives. The knowledge-to-action framework, in combination with the information assessment method (IAM), considering both the value-of-information construct and the conceptual model of acquisition-cognition-application, can be used to support the evaluation process of such resources. As an example, Stroke Engine is an evidence-based knowledge translation resource in stroke rehabilitation (assessments and interventions) for health professionals and students as well as individuals who have sustained a stroke and their relatives. According to Google Analytics, the website is perused >10,000 times per week. OBJECTIVE With the overall aim to improve the content available on Stroke Engine, we documented Stroke Engine users' perceptions of situational relevance, cognitive impact, intention to use, and expected patient and health benefits regarding the information consulted. METHODS A web-based survey anchored in the IAM was made available via an invitation tab. The IAM is a validated questionnaire that is designed to assess the value of information. Sociodemographic characteristics were also collected, and a space for free-text comments was provided. Descriptive statistics were used, and thematic analysis was used for the free-text comments. RESULTS The sample consisted of 6634 respondents. Health professionals (3663/6634, 55.22%) and students (2784/6634, 41.97%) represented 97.18% (6447/6634) of the total responses. The remaining 2.82% (187/6634) of the responses were from individuals who had sustained a stroke (87/6634, 1.31%) and their relatives (100/6634, 1.51%). Regarding situational relevance, assessments (including selecting, obtaining, and interpreting results from a test) was the main topic searched by health professionals (1838/3364, 54.64%) and students (1228/2437, 50.39%), whereas general information on stroke rehabilitation was the top-ranked topic for nearly two-thirds of the individuals with stroke (45/76, 59%) and their relatives (57/91, 63%). Cognitive impact was characterized by learning something new. Intention to use was high (4572/6379, 71.67%) among the respondents and varied in context (eg, refine a topic, research, class assignments, teaching, and education). Respondents commented on ways to improve content. Expected patient and health benefits such as improvement in health and well-being was the top-ranked category for all 4 subgroups, followed by the avoidance of unnecessary or inappropriate treatment for health professionals (183/623, 29.4%) and a feeling of being reassured for individuals with stroke (26/75, 35%) and their relatives (28/97, 29%). CONCLUSIONS Valuable feedback on Stroke Engine was obtained in terms of its accessibility, relevance for informational needs and retrieval, accuracy, and applicability; however, of utmost importance is the potential implementation of its evidence-based content in clinical practice and the perceived expected impact on patients, their relatives, and their health professionals. The feedback received allowed for corrections and the identification of key topics for further development.
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Affiliation(s)
- Annie Rochette
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
| | - Aliki Thomas
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Institute for Health Sciences Education, McGill University, Montreal, QC, Canada
| | - Nancy M Salbach
- Department of Physical Therapy, Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- The KITE Research Institute, University Health Network, Toronto, ON, Canada
| | - Brigitte Vachon
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
- Centre de recherche Fernand Séguin, Montreal, QC, Canada
| | - Anita Menon
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Lise Poissant
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
| | - Maurane Boutin
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
| | - Roland Grad
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Pierre Pluye
- Department of Family Medicine, McGill University, Montreal, QC, Canada
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Thomas A, Rochette A, George C, Iqbal MZ, Ataman R, St-Onge C, Boruff J, Renaud JS. The Definitions and Conceptualizations of the Practice Context in the Health Professions: A Scoping Review. J Contin Educ Health Prof 2023; 43:S18-S29. [PMID: 36877816 DOI: 10.1097/ceh.0000000000000490] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Health care professionals work in different contexts, which can influence professional competencies. Despite existing literature on the impact of context on practice, the nature and influence of contextual characteristics, and how context is defined and measured, remain poorly understood. The aim of this study was to map the breadth and depth of the literature on how context is defined and measured and the contextual characteristics that may influence professional competencies. METHODS A scoping review using Arksey and O'Malley's framework. We searched MEDLINE (Ovid) and CINAHL (EBSCO). Our inclusion criteria were studies that reported on context or relationships between contextual characteristics and professional competencies or that measured context. We extracted data on context definitions, context measures and their psychometric properties, and contextual characteristics influencing professional competencies. We performed numerical and qualitative analyses. RESULTS After duplicate removal, 9106 citations were screened and 283 were retained. We compiled a list of 67 context definitions and 112 available measures, with or without psychometric properties. We identified 60 contextual factors and organized them into five themes: Leadership and Agency, Values, Policies, Supports, and Demands. DISCUSSION Context is a complex construct that covers a wide array of dimensions. Measures are available, but none include the five dimensions in one single measure or focus on items targeting the likelihood of context influencing several competencies. Given that the practice context plays a critical role in health care professionals' competencies, stakeholders from all sectors (education, practice, and policy) should work together to address those contextual characteristics that can adversely influence practice.
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Affiliation(s)
- Aliki Thomas
- Dr. Thomas: Associate Professor, School of Physical and Occupational Therapy, Research Scientist, Institute of Health Sciences Education, McGill University. Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada . Dr. Rochette: Professor, Occupational Therapy Program, School of Rehabilitation, Université de Montréal. Centre for Interdisciplinary Research in Rehabilitation, Institut universitaire sur la réadaptation en défience physique de Montréal (IURDPM), Montreal, Quebec, Canada. Ms. George: School of Physical and Occupational Therapy, McGill University. Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada. Dr. Iqbal: Post-doctoral fellow, School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University. Centre for Interdisciplinary Research in Rehabilitation Montreal, Quebec, Canada. Ms. Ataman: School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University. Centre for Interdisciplinary Research in Rehabilitation Montreal, Quebec, Canada. Dr. St-Onge: Professor, Department of Medicine and Center for Health Professions Pedagogy, Université de Sherbrooke. Paul Grand'Maison de la Société des Médecins de l'Université de Sherbrooke - Research Chair in Medical Education, Sherbrooke, Quebec, Canada. Ms. Boruff, Associate Librarian, Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, Quebec, Canada. Dr. Renaud: Professor, Department of Family and Emergency Medicine, VITAM Research Center, Université Laval, Quebec, Quebec, Canada
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Roberge-Dao J, Maggio LA, Zaccagnini M, Rochette A, Shikako K, Boruff J, Thomas A. Challenges and future directions in the measurement of evidence-based practice: Qualitative analysis of umbrella review findings. J Eval Clin Pract 2023; 29:218-227. [PMID: 36440876 DOI: 10.1111/jep.13790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 10/16/2022] [Accepted: 10/25/2022] [Indexed: 11/29/2022]
Abstract
UNLABELLED RATIONALE, AIMS AND OBJECTIVES: An important aspect of scholarly discussions about evidence-based practice (EBP) is how EBP is measured. Given the conceptual and empirical developments in the study of EBP over the last 3 decades, there is a need to better understand how to best measure EBP in educational and clinical contexts. The aim of this study was to identify and describe the main challenges, recommendations for practice, and areas of future research in the measurement of EBP across the health professions as reported by systematic reviews (SRs). METHODS We conducted a secondary analysis of qualitative data obtained in the context of a previously published umbrella review that aimed to compare SRs on EBP measures. Two reviewers independently extracted excerpts from the results and discussion/conclusion sections of the 10 included SRs that aligned with the three research aims. An iterative six-phase reflexive thematic analysis according to Braun and Clarke was conducted. RESULTS Our thematic analysis produced five themes describing the main challenges associated with measuring EBP, four themes outlining main recommendations for practice, and four themes representing areas of future research. Challenges include limited psychometric testing and validity evidence for existing EBP measures; limitations with the self-report format; lack of construct clarity of EBP measures; inability to capture the complexity of the EBP process and outcomes; and the context-specific nature of EBP measures. Reported recommendations for practice include acknowledging the multidimensionality of EBP; adapting EBP measures to the context and re-examining the validity argument; and considering the feasibility and acceptability of measures. Areas of future research included the development of comprehensive, multidimensional EBP measures and the need for expert consensus on the operationalization of EBP. CONCLUSIONS This study suggests that existing measures may be insufficient in capturing the multidimensional, contextual and dynamic nature of EBP. There is a need for a clear operationalization of EBP and an improved understanding and application of validity theory.
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Affiliation(s)
- Jacqueline Roberge-Dao
- School of Physical and Occupational Therapy, McGill University, Montréal, Canada and Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Montréal, Canada
| | - Lauren A Maggio
- Medicine and Health Professions Education, Uniformed Services University, Bethesda, Maryland, USA
| | - Marco Zaccagnini
- School of Physical and Occupational Therapy, McGill University, Montréal, Canada and Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Montréal, Canada
| | - Annie Rochette
- School of Rehabilitation, Université de Montréal, Montréa, Canada and Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Université de Montréal, Montréal, Canada
| | - Keiko Shikako
- School of Physical and Occupational Therapy, McGill University, Montréal, Canada and Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Montréal, Canada
| | - Jill Boruff
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montréal, Canada
| | - Aliki Thomas
- School of Physical and Occupational Therapy and The Institute of Health Sciences Education, McGill University, Montréal, Canada and Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Montréal, Canada
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Iqbal MZ, Rochette A, Mayo NE, Valois MF, Bussières AE, Ahmed S, Debigaré R, Letts LJ, MacDermid JC, Ogourtsova T, Polatajko HJ, Rappolt S, Salbach NM, Thomas A. Exploring if and how evidence-based practice of occupational and physical therapists evolves over time: A longitudinal mixed methods national study. PLoS One 2023; 18:e0283860. [PMID: 37000834 PMCID: PMC10065251 DOI: 10.1371/journal.pone.0283860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 03/19/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Occupational therapists (OTs) and physiotherapists (PTs) are expected to provide evidence-based services to individuals living with disabilities. Despite the emphasis on evidence-based practice (EBP) by professional entry-level programs and professional bodies, little is known about their EBP competencies upon entry to practice and over time or what factors impact EBP use. The aim of the study was to measure and understand how EBP evolves over the first three years after graduation among Canadian OTs and PTs, and how individual and organizational factors impact the continuous use of EBP. METHODS A longitudinal, mixed methods sequential explanatory study. We administered a survey questionnaire measuring six EBP constructs (knowledge, attitudes, confidence, resources, use of EBP and evidence-based activities) annually, followed by focus group discussions with a subset of survey participants. We performed group-based trajectory modeling to identify trajectories of EBP over time, and a content analysis of qualitative data guided by the Theoretical Domains Framework. RESULTS Of 1700 graduates in 2016-2017, 257 (response rate = 15%) responded at baseline (T0) (i.e., at graduation), and 83 (retention rate = 32%), 75 (retention rate = 29%), and 74 (retention rate = 29%) participated at time point 1 (T1: one year into practice), time point 2 (T2: two years into practice, and time point 3 (T3: three years into practice) respectively. Group-based trajectory modeling showed four unique group trajectories for the use of EBP. Over 64% of participants (two trajectories) showed a decline in the use of EBP over time. Fifteen practitioners (7 OTs and 8 PTs) participated in the focus group discussions. Personal and peer experiences, client needs and expectations, and availability of resources were perceived to influence EBP the most. CONCLUSIONS Though a decline in EBP may be concerning, it is unclear if this decline is clinically meaningful and whether professional expertise can offset such declines. Stakeholder-concerted efforts towards the common goal of promoting EBP in education, practice and policy are needed.
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Affiliation(s)
- Muhammad Zafar Iqbal
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada
| | - Annie Rochette
- School of Rehabilitation, Université de Montréal, Montreal, Quebec, Canada
- Centre for Interdisciplinary Research in Rehabilitation, Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), Montreal, Quebec, Canada
| | - Nancy E Mayo
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
- Center for Outcomes Research and Evaluation (CORE), Research Institute of McGill University, Montreal, Quebec, Canada
| | - Marie-France Valois
- Department of Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - André E Bussières
- Département Chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada
| | - Sara Ahmed
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada
- Center for Outcomes Research and Evaluation (CORE), Research Institute of McGill University, Montreal, Quebec, Canada
| | - Richard Debigaré
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Laval, Quebec, Canada
| | - Lori Jean Letts
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Joy C MacDermid
- School of Physical Therapy and Department of Surgery, University of Western Ontario, London, Ontario, Canada
| | - Tatiana Ogourtsova
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada
- Research Center of the Jewish Rehabilitation Hospital, Centre intégré de santé et de services sociaux de Laval, Laval, Quebec, Canada
| | - Helene J Polatajko
- Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Susan Rappolt
- Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Nancy M Salbach
- Department of Physical Therapy, Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Aliki Thomas
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada
- Institute of Health Sciences Education, McGill University, Montreal, Quebec, Canada
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Beaudry L, Rochette A, Fortin S. Use of Adapted Dance to Intensify Subacute Rehabilitation Post-Stroke: A Qualitative Study on the Participation Experience and Active Participation Time. Altern Ther Health Med 2022; 28:40-51. [PMID: 34847069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Strategies are still needed to intensify stroke rehabilitation. As an alternative therapy, dance warrants examination since its multimodal nature appears to offer an enjoyable means of engaging in a rehabilitation activity. OBJECTIVES (1) To describe the participation experience in an adapted-dance group intervention, and (2) to study the patients' active participation time. METHODS In this embedded single-case study, the experience of participating patients, relatives and rehabilitation assistants was examined through semi-structured interviews. The verbatim transcripts underwent thematic analysis (qualitative method), while the patients' active participation time was examined through audiovisual recordings analyzed by type and length of engagement time (quasi-qualitative method). SETTING The study was conducted in the neurology department of a rehabilitation hospital. PARTICIPANTS The study included patients doing intensive functional rehabilitation post-stroke (≤25 days) (n = 6), relatives (n=4) and rehabilitation assistants (n = 4). Patients were recruited irrespective of their neurologic impairments. Their mean age was 71.0 years ± 9.9 years (range 59 to 86 years). INTERVENTION An adapted-dance group intervention ranging from moderate to somewhat hard/hard intensity was added to their rehabilitation program in the form of biweekly sessions of 55 minutes each, for up to 10 weeks. Carried out mainly on chairs, the intervention borrowed from dance approaches, rehabilitation practices, and movement-based educational approaches. RESULTS Observed adherence reached 82%. The participation experience involved 3 types of participation incentives (what motivated, fostered and facilitated their participation) and 4 types of perceived effort (unconscious, self-regulated, feasible and appropriate) conducive to participation. Mean motor engagement time of 50 minutes 4 seconds/session ± 2.53 minutes was observed in patients. CONCLUSION The use of an adapted-dance group intervention can contribute to the intensification of stroke rehabilitation and have a positive impact on motivation and perceived effort.
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Karo-Atar D, Ouladan S, Javkar T, Joumier L, Matheson MK, Merritt S, Westfall S, Rochette A, Gentile ME, Fontes G, Fonseca GJ, Parisien M, Diatchenko L, von Moltke J, Malleshaiah M, Gregorieff A, King IL. Helminth-induced reprogramming of the stem cell compartment inhibits type 2 immunity. J Exp Med 2022; 219:e20212311. [PMID: 35938990 PMCID: PMC9365672 DOI: 10.1084/jem.20212311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 03/23/2022] [Accepted: 07/11/2022] [Indexed: 12/13/2022] Open
Abstract
Enteric helminths form intimate physical connections with the intestinal epithelium, yet their ability to directly alter epithelial stem cell fate has not been resolved. Here we demonstrate that infection of mice with the parasite Heligmosomoides polygyrus bakeri (Hpb) reprograms the intestinal epithelium into a fetal-like state marked by the emergence of Clusterin-expressing revival stem cells (revSCs). Organoid-based studies using parasite-derived excretory-secretory products reveal that Hpb-mediated revSC generation occurs independently of host-derived immune signals and inhibits type 2 cytokine-driven differentiation of secretory epithelial lineages that promote their expulsion. Reciprocally, type 2 cytokine signals limit revSC differentiation and, consequently, Hpb fitness, indicating that helminths compete with their host for control of the intestinal stem cell compartment to promote continuation of their life cycle.
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Affiliation(s)
- Danielle Karo-Atar
- Department of Microbiology and Immunology, Meakins-Christie Laboratories, Research Institute of McGill University Health Centre, Montreal, Quebec, Canada
- McGill Interdisciplinary Initiative in Infection and Immunity, Montreal, Quebec, Canada
- McGill Regenerative Medicine Network, Montreal, Quebec, Canada
| | - Shaida Ouladan
- Department of Pathology, McGill University and Cancer Research Program, Research Institute of McGill University Health Centre, Montreal, Quebec, Canada
- McGill Regenerative Medicine Network, Montreal, Quebec, Canada
| | - Tanvi Javkar
- Department of Pathology, McGill University and Cancer Research Program, Research Institute of McGill University Health Centre, Montreal, Quebec, Canada
- McGill Regenerative Medicine Network, Montreal, Quebec, Canada
| | - Loick Joumier
- Division of Systems Biology, Montreal Clinical Research Institute, Montreal, QC, Canada
- Department of Biochemistry and Molecular Medicine, University of Montreal, Montreal, Quebec, Canada
| | | | - Sydney Merritt
- Department of Microbiology and Immunology, Meakins-Christie Laboratories, Research Institute of McGill University Health Centre, Montreal, Quebec, Canada
| | - Susan Westfall
- Department of Microbiology and Immunology, Meakins-Christie Laboratories, Research Institute of McGill University Health Centre, Montreal, Quebec, Canada
| | - Annie Rochette
- Department of Pathology, McGill University and Cancer Research Program, Research Institute of McGill University Health Centre, Montreal, Quebec, Canada
- McGill Regenerative Medicine Network, Montreal, Quebec, Canada
| | - Maria E. Gentile
- Department of Microbiology and Immunology, Meakins-Christie Laboratories, Research Institute of McGill University Health Centre, Montreal, Quebec, Canada
| | - Ghislaine Fontes
- Department of Microbiology and Immunology, Meakins-Christie Laboratories, Research Institute of McGill University Health Centre, Montreal, Quebec, Canada
| | - Gregory J. Fonseca
- McGill University Health Centre, Meakins-Christie Laboratories, Department of Medicine, Division of Quantitative Life Sciences, Montreal, Quebec, Canada
| | - Marc Parisien
- Department of Human Genetics, Allen Edwards Centre for Pain Research, McGill University, Montreal, Quebec, Canada
| | - Luda Diatchenko
- Department of Human Genetics, Allen Edwards Centre for Pain Research, McGill University, Montreal, Quebec, Canada
| | | | - Mohan Malleshaiah
- Division of Systems Biology, Montreal Clinical Research Institute, Montreal, QC, Canada
- Department of Biochemistry and Molecular Medicine, University of Montreal, Montreal, Quebec, Canada
- McGill Regenerative Medicine Network, Montreal, Quebec, Canada
| | - Alex Gregorieff
- Department of Pathology, McGill University and Cancer Research Program, Research Institute of McGill University Health Centre, Montreal, Quebec, Canada
- McGill Regenerative Medicine Network, Montreal, Quebec, Canada
| | - Irah L. King
- Department of Microbiology and Immunology, Meakins-Christie Laboratories, Research Institute of McGill University Health Centre, Montreal, Quebec, Canada
- McGill Interdisciplinary Initiative in Infection and Immunity, Montreal, Quebec, Canada
- McGill Regenerative Medicine Network, Montreal, Quebec, Canada
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Auger LP, Allegue DR, Morales E, Thomas A, Filiatrault J, Vachon B, Rochette A. Co-designing a Program to Improve Post-stroke Sexual Rehabilitation: The Promise of Innovative Methods. Front Rehabilit Sci 2022; 3:777897. [PMID: 36188972 PMCID: PMC9397714 DOI: 10.3389/fresc.2022.777897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 04/15/2022] [Indexed: 12/05/2022]
Abstract
Introduction Most people who sustain a stroke are likely to experience sexual difficulties during their recovery. However, few people get the opportunity to address sexuality during their rehabilitation because of factors related to the organization (e.g., culture), managers (e.g., lack of resources), clinicians (e.g., perceived lack of knowledge, skills, and comfort), and clients (e.g., taboo). A multifactorial program tailored to stakeholders' needs with various complementary interventions is needed to lead to a change of practice in post-stroke sexual rehabilitation. Objective To co-design with stakeholders (i.e., people with stroke, partners, clinicians, managers and researchers) a theory-driven multifactorial program to improve post-stroke sexual rehabilitation services. Methods This qualitative study will be conducted in four steps using an Intervention Mapping approach and a co-design methodology divided into four phases: (1) exploration; (2) co-design; (3) validation; and (4) development. Persons with stroke, partners, clinicians and managers from five distinct stroke rehabilitation centres in the province of Quebec (Canada), and researchers will be recruited to either participate in an advisory committee or working groups throughout the study. A combination of contributions from three different types of groups (advisory group, Lego® groups, work groups) will be used for data collection. Qualitative data analysis will first be realized by two independent reviewers using the Theoretical Domains Framework, and preliminary results of analysis will be validated with the advisory and working groups. Conclusion This study will lead to the co-design of the first theory-driven program intended to optimize post-stroke sexual rehabilitation services.
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Affiliation(s)
- Louis-Pierre Auger
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
- *Correspondence: Louis-Pierre Auger
| | - Dorra Rakia Allegue
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
| | - Ernesto Morales
- Department of Rehabilitation, Université Laval, Quebec City, QC, Canada
- Interdisciplinary Research Centre in Rehabilitation and Social Inclusion (CIRRIS), Quebec City, QC, Canada
| | - Aliki Thomas
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Johanne Filiatrault
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
- Montreal Geriatric University Institute Research Center, Montreal, QC, Canada
| | - Brigitte Vachon
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
- Montreal University Institute of Mental Health, Montreal, QC, Canada
| | - Annie Rochette
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
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Roberge-Dao J, Maggio LA, Zaccagnini M, Rochette A, Shikako-Thomas K, Boruff J, Thomas A. Quality, methods, and recommendations of systematic reviews on measures of evidence-based practice: an umbrella review. JBI Evid Synth 2022; 20:1004-1073. [PMID: 35220381 DOI: 10.11124/jbies-21-00118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES The objective of the review was to estimate the quality of systematic reviews on evidence-based practice measures across health care professions and identify differences between systematic reviews regarding approaches used to assess the adequacy of evidence-based practice measures and recommended measures. INTRODUCTION Systematic reviews on the psychometric properties of evidence-based practice measures guide researchers, clinical managers, and educators in selecting an appropriate measure for use. The lack of psychometric standards specific to evidence-based practice measures, in addition to recent findings suggesting the low methodological quality of psychometric systematic reviews, calls into question the quality and methods of systematic reviews examining evidence-based practice measures. INCLUSION CRITERIA We included systematic reviews that identified measures that assessed evidence-based practice as a whole or of constituent parts (eg, knowledge, attitudes, skills, behaviors), and described the psychometric evidence for any health care professional group irrespective of assessment context (education or clinical practice). METHODS We searched five databases (MEDLINE, Embase, CINAHL, PsycINFO, and ERIC) on January 18, 2021. Two independent reviewers conducted screening, data extraction, and quality appraisal following the JBI approach. A narrative synthesis was performed. RESULTS Ten systematic reviews, published between 2006 and 2020, were included and focused on the following groups: all health care professionals (n = 3), nurses (n = 2), occupational therapists (n = 2), physical therapists (n = 1), medical students (n = 1), and family medical residents (n = 1). The overall quality of the systematic reviews was low: none of the reviews assessed the quality of primary studies or adhered to methodological guidelines, and only one registered a protocol. Reporting of psychometric evidence and measurement characteristics differed. While all the systematic reviews discussed internal consistency, feasibility was only addressed by three. Many approaches were used to assess the adequacy of measures, and five systematic reviews referenced tools. Criteria for the adequacy of individual properties and measures varied, but mainly followed standards for patient-reported outcome measures or The Standards of Educational and Psychological Testing. Two hundred and four unique measures were identified across 10 reviews. One review explicitly recommended measures for occupational therapists, and four reviews identified adequate measures for all health care professionals (n = 3) and medical students (n = 1). The 27 measures deemed adequate by these five systematic reviews are described. CONCLUSIONS Our results suggest a need to improve the overall methodological quality and reporting of systematic reviews on evidence-based practice measures to increase the trustworthiness of recommendations and allow comprehensive interpretation by end-users. Risk of bias is common to all the included systematic reviews as the quality of primary studies was not assessed. The diversity of tools and approaches used to evaluate the adequacy of evidence-based practice measures reflects tensions regarding the conceptualization of validity, suggesting a need to reflect on the most appropriate application of validity theory to evidence-based practice measures. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42020160874.
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Affiliation(s)
- Jacqueline Roberge-Dao
- School of Physical and Occupational Therapy, McGill University, Montréal, QC, Canada Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Montréal, Qc, Canada Medicine and Health Professions Education, Uniformed Services University, Bethesda, MD, USA School of Rehabilitation, Université de Montréal, Montréal, QC, Canada Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montréal, QC, Canada
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18
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Rochette A, Roberge-Dao J, Roche L, Kehayia E, Ménard L, Robin JP, Sauvé M, Shikako-Thomas K, St-Onge M, Swaine B, Thomas A, Vallée-Dumas C, Fougeyrollas P. Advancing social inclusion of people with disabilities through awareness and training activities: A collaborative process between community partners and researchers. Patient Educ Couns 2022; 105:416-425. [PMID: 34045089 DOI: 10.1016/j.pec.2021.05.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 05/07/2021] [Accepted: 05/19/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE The main objectives were to 1) search and map current disability awareness and training activities in Quebec, Canada, 2) collectively reflect on these practices, and 3) develop a five-year strategic plan. METHODS We used an integrated knowledge translation approach whereby researchers and community partners were involved in all stages. This project consisted of two sequential phases: 1) an environmental scan (web review and interview) of current practices, and 2) a reflection process with an external expert-facilitator in social transformation. Outcome results and process data are reported. RESULTS We identified 129 activities (71 training, 58 awareness) from 39 organizations (from 123 organizations initially invited). A wide range of characteristics were collected for each activity which allowed for the identification of gaps. The working group met seven times in one year to discuss results from phase 1 and co-create a five-year strategic plan. Main priorities are 1) the development of a methodology for measuring collective impact and 2) content synchronization of activities. CONCLUSION Involvement of partners and researchers enabled a concerted and efficient approach to the development of a five-year strategic plan. PRACTICE IMPLICATIONS A transition committee led by partners will ensure implementation and sustainability of the plan across the province.
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Affiliation(s)
- Annie Rochette
- School of Rehabilitation, University of Montreal, Montreal, Canada; Centre for Interdisciplinary Research in Rehabilitation in greater Montreal (CRIR), Montreal, Canada.
| | - Jacqueline Roberge-Dao
- Centre for Interdisciplinary Research in Rehabilitation in greater Montreal (CRIR), Montreal, Canada; School of Physical and Occupational Therapy, McGill University, Montreal, Canada.
| | - Lise Roche
- Mirella and Lino Saputo Foundation, Montreal, Canada.
| | - Eva Kehayia
- Centre for Interdisciplinary Research in Rehabilitation in greater Montreal (CRIR), Montreal, Canada; School of Physical and Occupational Therapy, McGill University, Montreal, Canada.
| | - Lyne Ménard
- Keroul: Tourism and Culture for People with Restricted Physical Ability, Montreal, Canada.
| | - Jean-Pierre Robin
- International Network on the Disability Creation Process, Quebec, Canada.
| | - Méric Sauvé
- International Network on the Disability Creation Process, Quebec, Canada.
| | - Keiko Shikako-Thomas
- Centre for Interdisciplinary Research in Rehabilitation in greater Montreal (CRIR), Montreal, Canada; School of Physical and Occupational Therapy, McGill University, Montreal, Canada.
| | - Marc St-Onge
- Quebec's Association of Leisure for People with Disability (AQLPH), Trois-Rivières, Canada.
| | - Bonnie Swaine
- School of Rehabilitation, University of Montreal, Montreal, Canada; Centre for Interdisciplinary Research in Rehabilitation in greater Montreal (CRIR), Montreal, Canada.
| | - Aliki Thomas
- Centre for Interdisciplinary Research in Rehabilitation in greater Montreal (CRIR), Montreal, Canada; School of Physical and Occupational Therapy, McGill University, Montreal, Canada.
| | | | - Patrick Fougeyrollas
- Université Laval, Quebec, Canada; Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Quebec, Canada.
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19
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Gaboury I, Tousignant M, Corriveau H, Menear M, Le Dorze G, Rochefort C, Vachon B, Rochette A, Gosselin S, Michaud F, Bollen J, Dean S. Effects of Telerehabilitation on Patient Adherence to a Rehabilitation Plan: Protocol for a Mixed Methods Trial. JMIR Res Protoc 2021; 10:e32134. [PMID: 34709196 PMCID: PMC8587325 DOI: 10.2196/32134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/03/2021] [Accepted: 09/03/2021] [Indexed: 01/30/2023] Open
Abstract
Background Strong evidence supports beginning stroke rehabilitation as soon as the patient’s medical status has stabilized and continuing following discharge from acute care. However, adherence to rehabilitation treatments over the rehabilitation phase has been shown to be suboptimal. Objective The aim of this study is to assess the impact of a telerehabilitation platform on stroke patients’ adherence to a rehabilitation plan and on their level of reintegration into normal social activities, in comparison with usual care. The primary outcome is patient adherence to stroke rehabilitation (up to 12 weeks), which is hypothesized to influence reintegration into normal living. Secondary outcomes for patients include functional recovery and independence, depression, adverse events related to telerehabilitation, use of services (up to 6 months), perception of interprofessional shared decision making, and quality of services received. Interprofessional collaboration as well as quality of interprofessional shared decision making will be measured with clinicians. Methods In this interrupted time series with a convergent qualitative component, rehabilitation teams will be trained to develop rehabilitation treatment plans that engage the patient and family, while taking advantage of a telerehabilitation platform to deliver the treatment. The intervention will be comprised of 220 patients who will take part in stroke telerehabilitation with an interdisciplinary group of clinicians (telerehabilitation group) versus face-to-face standard of care (control group: n=110 patients). Results Our Research Ethics Board approved the study in June 2020. Data collection for the control group is underway, with another year planned before we begin the intervention phase. Conclusions This study will contribute to the minimization of both knowledge and practice gaps, while producing robust, in-depth data on the factors related to the effectiveness of telerehabilitation in a stroke rehabilitation continuum. Findings will inform best practice guidelines regarding telecare services and the provision of telerehabilitation, including recommendations for effective interdisciplinary collaboration regarding stroke rehabilitation. Trial Registration ClinicalTrials.gov NCT04440215; https://clinicaltrials.gov/ct2/show/NCT04440215 International Registered Report Identifier (IRRID) DERR1-10.2196/32134
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Affiliation(s)
- Isabelle Gaboury
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, QC, Canada
| | - Michel Tousignant
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Hélène Corriveau
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Matthew Menear
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec, QC, Canada
| | - Guylaine Le Dorze
- School of Audiology and Speech Therapy, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Christian Rochefort
- School of Nursing, Faculty of Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Brigitte Vachon
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Annie Rochette
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada
| | - Sylvie Gosselin
- Department of Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - François Michaud
- Department of Electrical and Computer Engineering, Faculty of Engineering, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Jessica Bollen
- Institute of Health Research, University of Exeter Medical School, Exeter, United Kingdom
| | - Sarah Dean
- Institute of Health Research, University of Exeter Medical School, Exeter, United Kingdom
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20
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Thomas A, Al Zoubi F, Mayo NE, Ahmed S, Amari F, Bussières A, Letts L, MacDermid JC, Polatajko HJ, Rappolt S, Salbach NM, Valois MF, Rochette A. Individual and organizational factors associated with evidence-based practice among physical and occupational therapy recent graduates: A cross-sectional national study. J Eval Clin Pract 2021; 27:1044-1055. [PMID: 33314562 DOI: 10.1111/jep.13518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 10/13/2020] [Accepted: 10/16/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Occupational therapy (OT) and physical therapy (PT) programs in Canada have moved to graduate-level entry education to address graduates' readiness for evidence-based practice (EBP). Whether rehabilitation professionals with advanced training in EBP are meeting their responsibilities as evidence-based professionals upon entry into practice and the factors that influence the use of evidence is unclear. The aim of this study was to examine the individual and organizational factors associated with the use of EBP and supporting evidence-based activities among graduates of professional OT and PT master's programs. METHODS A cross-sectional design using a survey of recent graduates of the 29 OT and PT programs in Canada. The survey measured six constructs supportive of EBP (ie, knowledge, attitudes, confidence, organizational resources, actual use of EBP, and evidence-based activities). Analyses consisted of descriptive statistics to characterize the sample and the different variables and ordinal multivariate regression analysis. RESULTS 257 graduates (15%) completed the survey. Attitudes towards EBP was positively associated both with evidence-based activities (odds ratio = 1.36 with a 95% CI: 1.22 to 1.52) and use of EBP (odds ratio = 1.23 with a 95% CI: 1.12 to 1.36); greater confidence was related to greater use of EBP (OR = 1.12, 95% CI: 1.01 to 1.24); and working in a private practice setting was found to be related to performing more evidence-based activities (odds ratio = 3.15, 95% CI: 1.40 to 7.12). CONCLUSIONS Despite a greater focus on EBP knowledge in these curricula across Canada, knowledge was not related to EBP use nor evidence-based activities upon entry into practice. On the other hand, attitudes, confidence and working in private practice were. University programs should consider curricular strategies that increase the use of EBP, provide opportunities to engage in evidence-based activities with an emphasis on promoting the development of positive attitudes towards EBP and increasing learners' confidence in their ability to be evidence-based professionals.
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Affiliation(s)
- Aliki Thomas
- Institute of Health Sciences Education, McGill University, Montreal, Quebec, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Quebec, Canada.,School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Fadi Al Zoubi
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Nancy E Mayo
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.,Center for Outcomes Research and Evaluation (CORE), Research Institute of McGill University, Montreal, Quebec, Canada
| | - Sara Ahmed
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Quebec, Canada.,School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.,Center for Outcomes Research and Evaluation (CORE), Research Institute of McGill University, Montreal, Quebec, Canada
| | - Fatima Amari
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - André Bussières
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Quebec, Canada.,School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.,Département Chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada
| | - Lori Letts
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Joy C MacDermid
- School of Physical Therapy and Department of Surgery, University of Western Ontario, London, Ontario, Canada
| | - Helene J Polatajko
- Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, University of Toronto Neuroscience Program, University of Toronto, Toronto, Ontario, Canada
| | - Susan Rappolt
- Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Nancy M Salbach
- Department of Physical Therapy, Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | | | - Annie Rochette
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Quebec, Canada.,School of Rehabiliation, Université de Montréal, Montreal, Quebec, Canada
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21
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Auger LP, Aubertin M, Grondin M, Auger C, Filiatrault J, Rochette A. Assessment methods in sexual rehabilitation after stroke: a scoping review for rehabilitation professionals. Disabil Rehabil 2021; 44:4126-4148. [PMID: 33689511 DOI: 10.1080/09638288.2021.1889047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE The aim was to identify and describe the assessment methods used by rehabilitation professionals to evaluate sexuality for individuals post-stroke, as well as the domains of sexuality addressed. METHODS Seven databases were selected for this scoping review. Articles needed to meet these inclusion criteria: published studies with a sample of ≥ 50% stroke clients and describing a quantitative or qualitative assessment method that could be used by rehabilitation professionals. This study was conducted following the PRISMA guidelines and domains of sexuality were categorized using the ICF core set for stroke. RESULTS Of the 2447 articles reviewed, the 96 that met the selection criteria identified a total of 116 assessment methods classified as standardized assessment tools (n = 62), original questionnaires (n = 28), semi-structured interviews (n = 16) or structured interviews (n = 10). Sexual functions were predominantly assessed using standardized tools, while intimate relationships and partner's perspective were generally addressed more by original questionnaires and qualitative methods. A stepwise approach combining relevant assessment methods is presented. CONCLUSIONS Individually, these diverse assessment methods addressed a limited scope of relevant domains. Future research should combine quantitative and qualitative methods to encompass most domains of sexuality of concern to post-stroke individuals.IMPLICATIONS FOR REHABILITATIONMost of the studies reviewed here used quantitative methods to assess sexuality, rather than qualitative methods, and mostly used standardized assessment tools.Few assessment methods covered all domains related to sexuality.Qualitative methods and standardized assessment tools were shown to be complementary, therefore emphasizing the added value of mixed methods in assessing sexuality after a stroke.Among the methods that were reviewed, certain would be more suitable for the identification of the need to address sexuality (e.g., Life Satisfaction Checklist-11) and others to assess more thoroughly sexuality (e.g., Change in Sexual Functioning Questionnaire (CSFQ-14)).
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Affiliation(s)
- Louis-Pierre Auger
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada
| | - Mélanie Aubertin
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada
| | - Myrian Grondin
- Marguerite-d'Youville Library, Université de Montréal, Montreal, Canada
| | - Claudine Auger
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada
| | - Johanne Filiatrault
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada.,Montreal Geriatric University Institute Research Center, Montreal, Canada
| | - Annie Rochette
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada
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22
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Auger LP, Pituch E, Filiatrault J, Courtois F, Rochette A. Implementation of a sexuality interview guide in stroke rehabilitation: a feasibility study. Disabil Rehabil 2021; 44:4014-4022. [PMID: 33561368 DOI: 10.1080/09638288.2021.1881625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Although people who sustain a stroke can experience sexual difficulties, few address them during rehabilitation. OBJECTIVES Explore the feasibility of implementing a Sexuality Interview Guide (SIG) in stroke rehabilitation and describe the factors perceived as influencing its implementation. MATERIALS AND METHODS Using a mixed research design, the SIG was implemented for four months in a rehabilitation hospital. The frequency with which clinicians addressed sexuality and their level of comfort pre-post implementation was measured. Perceived factors influencing implementation were determined through individual interviews and focus groups with five stroke clients, 15 clinicians and a coordinator. A paired-specimen Wilcoxon test was used to explore differences in pre- post-level of comfort. Qualitative data was analyzed by two independent evaluators using thematic analysis. RESULTS The SIG was used 28 times and clinicians' level of comfort in addressing sexuality improved significantly (p = 0.001). The factors perceived as influencing implementation were: the acceptability of the SIG, the individual characteristics, the context of the rehabilitation hospital and the implementation process. CONCLUSION This study showed that the SIG can be used in stroke rehabilitation and that, with sufficient financial and human resources, and training for clinicians, it would be feasible to implement it in usual care. Implications for rehabilitation The Sexuality Interview Guide (SIG) can be used in stroke rehabilitation and helps clinicians to target stroke clients who want to include sexuality in their rehabilitation. The best time to approach sexuality using the SIG, according to all participants, was in outpatient rehabilitation. For inpatient clients, it was more appropriate to use the SIG as they approach a weekend home trial or rehabilitation discharge. Training for clinicians working in post-stroke sexual rehabilitation, administrative policies and procedures and access to a sexual health specialist for consultation or referral purpose, would be important facilitators in integrating sexuality into clinical practices.
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Affiliation(s)
- Louis-Pierre Auger
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada
| | - Evelina Pituch
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada
| | - Johanne Filiatrault
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada.,Research Center of the Institut Universitaire de gériatrie de Montréal, Montreal, Canada
| | - Frédérique Courtois
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada.,Department of Sexology, Faculty of Human Sciences, Université du Québec à Montréal, Montreal, Canada
| | - Annie Rochette
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada
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23
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Auger LP, Grondin M, Aubertin M, Marois A, Filiatrault J, Rochette A. Interventions used by allied health professionals in sexual rehabilitation after stroke: A systematic review. Top Stroke Rehabil 2020; 28:557-572. [DOI: 10.1080/10749357.2020.1845014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Louis-Pierre Auger
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
| | - Myrian Grondin
- Marguerite-d’Youville Library, Université de Montréal, Montreal, QC, Canada
| | - Mélanie Aubertin
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Audrey Marois
- Centre intégré de santé et de services sociaux des Laurentides, Saint-Jérôme, QC, Canada
| | - Johanne Filiatrault
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
- Marguerite-d’Youville Library, Université de Montréal, Montreal, QC, Canada
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre intégré de santé et de services sociaux des Laurentides, Saint-Jérôme, QC, Canada
| | - Annie Rochette
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
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Montpetit-Tourangeau K, Kairy D, Ahmed S, Anaby D, Bussières A, Lamontagne MÈ, Rochette A, Shikako-Thomas K, Thomas A. A strategic initiative to facilitate knowledge translation research in rehabilitation. BMC Health Serv Res 2020; 20:973. [PMID: 33097043 PMCID: PMC7585309 DOI: 10.1186/s12913-020-05772-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 09/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While there is a growing body of literature supporting clinical decision-making for rehabilitation professionals, suboptimal use of evidence-based practices in that field persists. A strategic initiative that ensures the relevance of the research and its implementation in the context of rehabilitation could 1) help improve the coordination of knowledge translation (KT) research and 2) enhance the delivery of evidence-based rehabilitation services offered to patients with physical disabilities. This paper describes the process and methods used to develop a KT strategic initiative aimed at building capacity and coordinating KT research in physical rehabilitation and its strategic plan; it also reports the initial applications of the strategic plan implementation. METHODS We used a 3-phase process consisting of an online environmental scan to identify the extent of KT research activities in physical rehabilitation in Quebec, Canada. Data from the environmental scan was used to develop a strategic plan that structures KT research in physical rehabilitation. Seven external KT experts in health science reviewed the strategic plan for consistency and applicability. RESULTS Sixty-four KT researchers were identified and classified according to the extent of their level of involvement in KT. Ninety-six research projects meeting eligibility criteria were funded by eight of the fourteen agencies and organizations searched. To address the identified gaps, a 5-year strategic plan was developed, containing a mission, a vision, four main goals, nine strategies and forty-two actions. CONCLUSION Such initiatives can help guide researchers and relevant key stakeholders, to structure, organize and advance KT research in the field of rehabilitation. The strategies are being implemented progressively to meet the strategic initiative's mission and ultimately enhance users' rehabilitation services.
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Affiliation(s)
- Katherine Montpetit-Tourangeau
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, P.O. Box 6128, Station Centre-Ville, Montreal, Quebec, H3C 3J7, Canada. .,Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada.
| | - Dahlia Kairy
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, P.O. Box 6128, Station Centre-Ville, Montreal, Quebec, H3C 3J7, Canada.,Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada
| | - Sara Ahmed
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada.,School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, 3654 Sir William Osler, Montreal, Quebec, H3G 1Y5, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, 1020 Pine Avenue West, Montreal, Quebec, H3A 1A2, Canada
| | - Dana Anaby
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada.,School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, 3654 Sir William Osler, Montreal, Quebec, H3G 1Y5, Canada.,CanChild Centre for Childhood Disability Research, McMaster University, 1400 Main Street West, Room 408, Hamilton, Ontario, L8S 1C7, Canada
| | - André Bussières
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada.,School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, 3654 Sir William Osler, Montreal, Quebec, H3G 1Y5, Canada.,Département Chiropratique, Université du Québec à Trois-Rivières, 3351, boul. Des Forges, C. P. 500, Trois-Rivières, Quebec, G9A 5H, Canada
| | - Marie-Ève Lamontagne
- Département de réadaptation, Université Laval, Quebec, Quebec, G1V 0A6, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration, Institut de Réadaptation en Déficience Physique de Québec, 525 Boul Wilfrid-Hamel, Quebec, Quebec, G1M 2S8, Canada
| | - Annie Rochette
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, P.O. Box 6128, Station Centre-Ville, Montreal, Quebec, H3C 3J7, Canada.,Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada
| | - Keiko Shikako-Thomas
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada.,School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, 3654 Sir William Osler, Montreal, Quebec, H3G 1Y5, Canada.,CanChild Centre for Childhood Disability Research, McMaster University, 1400 Main Street West, Room 408, Hamilton, Ontario, L8S 1C7, Canada
| | - Aliki Thomas
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada.,School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, 3654 Sir William Osler, Montreal, Quebec, H3G 1Y5, Canada.,Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, 1110 Pine Avenue West, Montreal, Quebec, H3G 1A3, Canada
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25
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Rochette A, Dugas A, Morissette-Gravel AS. Inclusion of relatives in stroke rehabilitation: Perception of quality of services they received in the context of early supported discharged (ESD), in- and out-patient services. Top Stroke Rehabil 2020; 28:142-152. [PMID: 32657250 DOI: 10.1080/10749357.2020.1790731] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Relatives of stroke patients should be an integral part of the continuum of rehabilitation services. OBJECTIVE The objective was to describe their perception of the quality of the services they received in the context of early supported discharged (ESD), in- and out-patient rehabilitation services. METHODS Descriptive study using the Quality of Services Questionnaire for Relatives post-stroke (QSQR) completed online by relatives after the patient's discharge. It consists of 22 statements with respect to three subscales: 1) the training/instructions, 2) the information provision and 3) the organizational process of the service offer. Space is allowed for free comments and two open-ended questions. Quantitative data were analyzed descriptively, and we used a content analysis for qualitative data. RESULTS One-third (30/90; 33.3%) of the sample are composed of relatives aged 55 and under, with a majority (81%) of women and 51.3% of spouses. The training/instructions and information provision were perceived positively with a mean % agreement at 85.0 ± 29.6 and 84.8 ± 22.4, respectively. The mean % agreement was 91.4 ± 17.8 for the organizational process subscale. A significantly higher score (p = 0,03; Kruskal Wallis test) was found for out-patient services (n = 20) as compared to ESD (n = 29) or in-patient rehabilitation (n = 41). Qualitatively, a lack of involvement of relatives was mentioned as well as a lack of personalized information about stroke and its consequences and provision of resources available. However, communication between professionals, their availability, and their professionalism were appreciated. CONCLUSION Despite quantitative high scores, qualitative data allowed the identification of concrete avenues for improvement to truly and systematically include relatives in stroke rehabilitation.
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Affiliation(s)
- Annie Rochette
- Occupational Therapy Program, School of Rehabilitation, University of Montreal , Montreal, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR) , Canada
| | - Ariane Dugas
- Occupational Therapy Program, School of Rehabilitation, University of Montreal , Montreal, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR) , Canada
| | - Anne-Sophie Morissette-Gravel
- Occupational Therapy Program, School of Rehabilitation, University of Montreal , Montreal, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR) , Canada
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Rochette A, Brousseau M, Vachon B, Engels C, Amari F, Thomas A. What occupational therapists' say about their competencies' enactment, maintenance and development in practice? A two-phase mixed methods study. BMC Med Educ 2020; 20:191. [PMID: 32539754 PMCID: PMC7294620 DOI: 10.1186/s12909-020-02087-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 05/21/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Understanding how professional competencies are actually enacted in clinical practice can help university programs better prepare their graduates. The study aimed to describe 1) the perceived competency level of occupational therapists holding an entry-to-practice master's degree 2) the factors perceived as impacting the enactment of competencies; and 3) the strategies used to maintain and further develop level of competency in the seven practice roles: expert in enabling occupation, communicator, collaborator, practice manager, change agent, scholarly practitioner and professional. METHODS Descriptive two-phase mixed methods sequential design. The quantitative phase consisted of an online survey sent to all occupational therapists holding an entry-to-practice master's degree in Quebec, Canada (n = 1196), followed by focus group discussions with a subset of participants. Analysis used descriptive statistics and the Framework Approach for content analysis of focus group data. Competencies were theoretically anchored into the Profile of Occupational Therapist Practice in Canada (an equivalent to CanMEDS framework) and we used the Theoretical Domain Framework to collect and describe perceived factors and strategies. RESULTS Response rate to Phase 1 was 26.5% (n = 317/1196). The communicator, collaborator and professional roles were perceived as highly solicited in practice, valued and were rated more frequently at a higher competency level as compared to the other four roles (expert, manager, change agent and scholar roles). Focus group participants (n = 16) mentioned that both individual and organisational factors influence enactment of competencies. Consulting colleagues was the preferred strategy to support the scholar role, often described as foundational for the development of expertise. CONCLUSION This descriptive study provides valuable information as to how the seven roles are enacted in practice. Though the scholar role is highly valued by clinicians and organizations, insufficient time is allotted to searching for evidence and reflection in practice. Strategies emerging from the results are mainly directed toward this role with an emphasis on using of peers as a source of evidence. Future studies could explore how contextual factors influence the enactment of competencies across different professions as well as how these evolve over time.
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Affiliation(s)
- Annie Rochette
- Occupational Therapy Program, School of Rehabilitation, University of Montreal, C.P. 6128, Succursale Centre-Ville, Pavillon Parc, Montréal, Québec, H3C 3J7, Canada.
- Centre for Interdisciplinary Research in Rehabilitation in greater Montreal (CRIR), Montréal, Canada.
| | - Martine Brousseau
- Occupational Therapy Department, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Brigitte Vachon
- Occupational Therapy Program, School of Rehabilitation, University of Montreal, C.P. 6128, Succursale Centre-Ville, Pavillon Parc, Montréal, Québec, H3C 3J7, Canada
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Canada
| | - Cynthia Engels
- Univ Paris Est Creteil, INSERM, IMRB, Equipe CEpiA, F-94010, Creteil, France
- Univ Paris Est Creteil, UFR de santé, Institut de formation en ergothérapie, F-94010, Creteil, France
| | - Fatima Amari
- School of Physical and Occupational Therapy, McGill University, Montréal, Canada
| | - Aliki Thomas
- Centre for Interdisciplinary Research in Rehabilitation in greater Montreal (CRIR), Montréal, Canada
- School of Physical and Occupational Therapy, McGill University, Montréal, Canada
- Institute of Health Sciences Education, McGill University, Montréal, Canada
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Esmail A, Poncet F, Auger C, Rochette A, Dahan-Oliel N, Labbé D, Kehayia E, Billebaud C, de Guise É, Lessard I, Ducharme I, Vermeersch O, Swaine B. The role of clothing on participation of persons with a physical disability: A scoping review. Appl Ergon 2020; 85:103058. [PMID: 32174346 DOI: 10.1016/j.apergo.2020.103058] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 01/13/2020] [Accepted: 01/13/2020] [Indexed: 06/10/2023]
Abstract
Determining ways to facilitate participation of persons with a physical disability is crucial and clothing may play a central role. This review aims to synthesize and examine the role of clothing on participation of persons with a physical disability. Six research databases and grey literature were searched following Arksey & O'Malley's six steps, including multiple expert consultations. English and French articles contributing to how clothing affects participation were included and tabulated based on the International Classification of Functioning, Disability and Health. Fifty-seven articles and 88 websites were included. A variety of stakeholder perspectives, diagnoses, and types of clothing were represented. Clothing mostly influences mobility and self-care, as well as various personal factors. Forty-nine percent of articles reported essential clothing design features to consider. Clothing is an important and complex environmental factor that interacts with all health domains, including participation. Future research should consider intersectoral initiatives.
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Affiliation(s)
- Alida Esmail
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR-Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM) of the CIUSSS du Centre-Sud-de-l'Île-de-Montréal), Montreal, Quebec, Canada
| | - Frédérique Poncet
- Department of Psychology, Concordia University, Montreal, Quebec, Canada; CRIR-Institut Nazareth et Louis-Braille of the CISSS de la Montérégie-Centre, Longueuil, Quebec, Canada
| | - Claudine Auger
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR-Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM) of the CIUSSS du Centre-Sud-de-l'Île-de-Montréal), Montreal, Quebec, Canada
| | - Annie Rochette
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR-Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM) of the CIUSSS du Centre-Sud-de-l'Île-de-Montréal), Montreal, Quebec, Canada
| | - Noémi Dahan-Oliel
- Shriners Hospitals for Children-Canada, Montreal, Quebec, Canada; School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Delphine Labbé
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Eva Kehayia
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR-Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM) of the CIUSSS du Centre-Sud-de-l'Île-de-Montréal), Montreal, Quebec, Canada; School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Christophe Billebaud
- Rhizome Strategies, Montreal, Quebec, Canada; La Piscine, Montreal, Quebec, Canada
| | - Élaine de Guise
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR-Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM) of the CIUSSS du Centre-Sud-de-l'Île-de-Montréal), Montreal, Quebec, Canada; Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | | | | | | | - Bonnie Swaine
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR-Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM) of the CIUSSS du Centre-Sud-de-l'Île-de-Montréal), Montreal, Quebec, Canada.
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Granikov V, Grad R, El Sherif R, Shulha M, Chaput G, Doray G, Lagarde F, Rochette A, Tang DL, Pluye P. The Information Assessment Method: Over 15 years of research evaluating the value of health information. EFI 2020. [DOI: 10.3233/efi-190348] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Vera Granikov
- School of Information Studies, McGill University, Montréal, QC, Canada
- Department of Family Medicine, McGill University, Montréal, QC, Canada
| | - Roland Grad
- Department of Family Medicine, McGill University, Montréal, QC, Canada
| | - Reem El Sherif
- Department of Family Medicine, McGill University, Montréal, QC, Canada
| | - Michael Shulha
- School of Information Studies, McGill University, Montréal, QC, Canada
- Department of Family Medicine, McGill University, Montréal, QC, Canada
| | - Genevieve Chaput
- Division of Supportive and Palliative Medicine, McGill University Health Centre and Departments of Oncology and Family Medicine, McGill University, Montréal, QC, Canada
| | - Genevieve Doray
- Naître et grandir, Fondation Lucie et André, Chagnon, Montréal, QC, Canada
| | | | - Annie Rochette
- School of Rehabilitation, University of Montreal and Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montréal, QC, Canada
| | - David Li Tang
- School of Information Studies, McGill University, Montréal, QC, Canada
- Department of Family Medicine, McGill University, Montréal, QC, Canada
| | - Pierre Pluye
- Department of Family Medicine, McGill University, Montréal, QC, Canada
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Doiron-Cadrin P, Lafrance S, Saulnier M, Cournoyer É, Roy JS, Dyer JO, Frémont P, Dionne C, MacDermid JC, Tousignant M, Rochette A, Lowry V, Bureau NJ, Lamontagne M, Coutu MF, Lavigne P, Desmeules F. Shoulder Rotator Cuff Disorders: A Systematic Review of Clinical Practice Guidelines and Semantic Analyses of Recommendations. Arch Phys Med Rehabil 2020; 101:1233-1242. [PMID: 32007452 DOI: 10.1016/j.apmr.2019.12.017] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 12/12/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To perform a systematic review of clinical practice guidelines (CPGs) and semantic analysis of specific clinical recommendations for the management of rotator cuff disorders in adults. DATA SOURCES A systematic bibliographic search was conducted up until May 2018 in Medline, Embase, and Physiotherapy Evidence Database, or PEDro, databases, in addition to 12 clinical guidelines search engines listed on the Appraisal of Guidelines for Research and Evaluation (AGREE) website. STUDY SELECTION Nine CPGs on the management of rotator cuff disorders in adults or workers, available in English or French, and published from January 2008 onward, were included and screened by 2 independent reviewers. DATA EXTRACTION CPG methodology was assessed with the AGREE II checklist. A semantic analysis was performed to compare the strength of similar recommendations based on their formulation. The recommendations were categorized in a standardized manner considering the following 4 levels: "essential," "recommended," "may be recommended," and "not recommended." DATA SYNTHESIS Methodological quality was considered high for 3 CPGs and low for 6. All CPGs recommended active treatment modalities, such as an exercise program in the management of rotator cuff disorders. Acetaminophen or nonsteroidal anti-inflammatory drug prescriptions and corticosteroid injections were presented as modalities that may be recommended to decrease pain. Recommendations related to medical imagery and surgical opinion varied among the guidelines. The most commonly recommended return-to-work strategies included intervening early, use of a multidisciplinary approach, and adaptation of work organization. CONCLUSIONS Only 3 CPGs were of high quality. The development of more rigorous CPGs is warranted.
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Affiliation(s)
- Patrick Doiron-Cadrin
- Maisonneuve-Rosemont Hospital Research Center, University of Montréal Affiliated Research Center, Montréal, Québec, Canada
| | - Simon Lafrance
- Maisonneuve-Rosemont Hospital Research Center, University of Montréal Affiliated Research Center, Montréal, Québec, Canada
| | - Marie Saulnier
- Maisonneuve-Rosemont Hospital Research Center, University of Montréal Affiliated Research Center, Montréal, Québec, Canada
| | - Émie Cournoyer
- Maisonneuve-Rosemont Hospital Research Center, University of Montréal Affiliated Research Center, Montréal, Québec, Canada
| | - Jean-Sébastien Roy
- Department of Rehabilitation, Faculty of Medicine, Laval University, Québec City, Québec, Canada; Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Québec City, Québec, Canada
| | - Joseph-Omer Dyer
- School of Rehabilitation, Faculty of Medicine, University of Montréal, Montréal, Québec, Canada
| | - Pierre Frémont
- Department of Rehabilitation, Faculty of Medicine, Laval University, Québec City, Québec, Canada
| | - Clermont Dionne
- Department of Rehabilitation, Faculty of Medicine, Laval University, Québec City, Québec, Canada; Laval University Hospital Center of Research, Québec City, Québec, Canada
| | - Joy C MacDermid
- School of Physical Therapy, Western University, London, Ontario, Canada
| | - Michel Tousignant
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Sherbrooke University, Sherbrooke, Québec, Canada
| | - Annie Rochette
- School of Rehabilitation, Faculty of Medicine, University of Montréal, Montréal, Québec, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montréal, Montréal, Québec, Canada
| | - Véronique Lowry
- Maisonneuve-Rosemont Hospital Research Center, University of Montréal Affiliated Research Center, Montréal, Québec, Canada
| | - Nathalie J Bureau
- Department of Radiology, Oncology and Nuclear Medicine, Faculty of Medicine, University of Montréal, Montréal, Québec, Canada; University of Montréal Hospital Research Center (CHUM), Montréal, Québec, Canada
| | - Martin Lamontagne
- Department of Medicine, Faculty of Medicine, University of Montréal, Montréal, Québec, Canada
| | - Marie-France Coutu
- Centre for Work Disability Prevention and Rehabilitation, Charles Le Moyne Hospital Research Centre affiliated with Sherbrooke University, Longueuil, Canada
| | - Patrick Lavigne
- Maisonneuve-Rosemont Hospital Research Center, University of Montréal Affiliated Research Center, Montréal, Québec, Canada; Department of Surgery, Faculty of Medicine, University of Montréal, Montréal, Québec, Canada
| | - François Desmeules
- Maisonneuve-Rosemont Hospital Research Center, University of Montréal Affiliated Research Center, Montréal, Québec, Canada; School of Rehabilitation, Faculty of Medicine, University of Montréal, Montréal, Québec, Canada.
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Mountain A, Patrice Lindsay M, Teasell R, Salbach NM, de Jong A, Foley N, Bhogal S, Bains N, Bowes R, Cheung D, Corriveau H, Joseph L, Lesko D, Millar A, Parappilly B, Pikula A, Scarfone D, Rochette A, Taylor T, Vallentin T, Dowlatshahi D, Gubitz G, Casaubon LK, Cameron JI. Canadian Stroke Best Practice Recommendations: Rehabilitation, Recovery, and Community Participation following Stroke. Part Two: Transitions and Community Participation Following Stroke. Int J Stroke 2020; 15:789-806. [DOI: 10.1177/1747493019897847] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The sixth update of the Canadian Stroke Best Practice Recommendations for Transitions and Community Participation following Stroke is a comprehensive set of evidence-based guidelines addressing issues faced by people following an acute stroke event. Establishing a coordinated and seamless system of care that supports progress achieved during the initial recovery stages throughout the transition to the community is more essential than ever as the medical complexity of people with stroke is also on the rise. All members of the health-care team engaged with people with stroke, their families, and caregivers are responsible for partnerships and collaborations to ensure successful transitions and return to the community following stroke. These guidelines reinforce the growing and changing body of research evidence available to guide ongoing screening, assessment, and management of individuals following stroke as they move from one phase and stage of care to the next without “falling through the cracks.” It also recognizes the growing role of family and informal caregivers in providing significant hours of support that disrupt their own lives and responsibilities and addresses their support and educational needs. According to Statistics Canada, in 2012, eight million Canadians provided care to family members or friends with a long-term health condition, disability, or problems associated with aging. These recommendations incorporate aspects that were previously in the rehabilitation module for the purposes of streamlining, and both modules should be reviewed in order to provide comprehensive care addressing recovery and community reintegration and participation. These recommendations cover topics related to support and education of people with stroke, families, and caregivers during transitions and community reintegration. They include interprofessional planning and communication, return to driving, vocational roles, leisure activities and relationships and sexuality, and transition to long-term care.
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Affiliation(s)
- Anita Mountain
- Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, Canada
- Nova Scotia Rehabilitation Centre Site, Queen Elizabeth II Health Sciences Centre, Halifax, Canada
| | | | - Robert Teasell
- Western University, London, Canada
- Stroke Rehabilitation Program, Parkwood Hospital, London, Canada
| | - Nancy M Salbach
- Department of Physical Therapy, University of Toronto, Canada
| | | | | | | | - Naresh Bains
- Department of Neurosciences, University of Alberta Hospital, Edmonton, Canada
| | - Rebecca Bowes
- ICAN Independence Centre and Network, Sudbury, Canada
| | - Donna Cheung
- South East Toronto Stroke Network, Toronto, Canada
| | - Helene Corriveau
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada
| | | | - Dana Lesko
- West GTA Stroke Network, Trillium Health Partners, Mississauga, Canada
| | | | | | | | | | - Annie Rochette
- School of Rehabilitation, University of Montreal, Montreal, Canada
| | - Trudy Taylor
- Carewest Dr. Vernon Fanning Centre, Calgary, Canada
| | - Tina Vallentin
- Stroke Program, Hamilton Health Sciences, Hamilton, Canada
| | | | - Gord Gubitz
- Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, Canada
- Stroke Program, Queen Elizabeth II Health Sciences Centre, Halifax, Canada
| | - Leanne K Casaubon
- Toronto Western Hospital, University Health Network, Toronto, Canada
| | - Jill I Cameron
- Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
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Teasell R, Salbach NM, Foley N, Mountain A, Cameron JI, Jong AD, Acerra NE, Bastasi D, Carter SL, Fung J, Halabi ML, Iruthayarajah J, Harris J, Kim E, Noland A, Pooyania S, Rochette A, Stack BD, Symcox E, Timpson D, Varghese S, Verrilli S, Gubitz G, Casaubon LK, Dowlatshahi D, Lindsay MP. Canadian Stroke Best Practice Recommendations: Rehabilitation, Recovery, and Community Participation following Stroke. Part One: Rehabilitation and Recovery Following Stroke; 6th Edition Update 2019. Int J Stroke 2020; 15:763-788. [PMID: 31983296 DOI: 10.1177/1747493019897843] [Citation(s) in RCA: 158] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The sixth update of the Canadian Stroke Best Practice Recommendations: Rehabilitation, Recovery, and Reintegration following Stroke. Part one: Rehabilitation and Recovery Following Stroke is a comprehensive set of evidence-based guidelines addressing issues surrounding impairments, activity limitations, and participation restrictions following stroke. Rehabilitation is a critical component of recovery, essential for helping patients to regain lost skills, relearn tasks, and regain independence. Following a stroke, many people typically require rehabilitation for persisting deficits related to hemiparesis, upper-limb dysfunction, pain, impaired balance, swallowing, and vision, neglect, and limitations with mobility, activities of daily living, and communication. This module addresses interventions related to these issues as well as the structure in which they are provided, since rehabilitation can be provided on an inpatient, outpatient, or community basis. These guidelines also recognize that rehabilitation needs of people with stroke may change over time and therefore intermittent reassessment is important. Recommendations are appropriate for use by all healthcare providers and system planners who organize and provide care to patients following stroke across a broad range of settings. Unlike the previous set of recommendations, in which pediatric stroke was included, this set of recommendations includes primarily adult rehabilitation, recognizing many of these therapies may be applicable in children. Recommendations related to community reintegration, which were previously included within this rehabilitation module, can now be found in the companion module, Rehabilitation, Recovery, and Community Participation following Stroke. Part Two: Transitions and Community Participation Following Stroke.
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Affiliation(s)
- Robert Teasell
- Stroke Rehabilitation Program, 60446Parkwood Hospital, London, Canada
- Western University, London, Canada
| | - Nancy M Salbach
- Department of Physical Therapy, University of Toronto, Toronto, Canada
| | | | - Anita Mountain
- Division of Physical Medicine and Rehabilitation, 3688Dalhousie University, Halifax, Canada
- Queen Elizabeth II Health Sciences Centre, Nova Scotia Rehabilitation Centre Site, Halifax, Canada
| | - Jill I Cameron
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Andrea de Jong
- 33484Heart and Stroke Foundation of Canada, Toronto, Canada
| | - Nicole E Acerra
- Neurosciences and Physical Therapy, Vancouver Coastal Health, Vancouver, Canada
| | - Diana Bastasi
- School of Physical and Occupational Therapy, 5620McGill University, Montréal, Canada
| | - Sherri L Carter
- Department of Psychology and Neuroscience, 3688Dalhousie University, Halifax, Canada
| | - Joyce Fung
- School of Physical and Occupational Therapy, 5620McGill University, Montréal, Canada
- Jewish Rehabilitation Hospital (CISSS-Laval) research site of CRIR, Montréal, Canada
| | - Mary-Lou Halabi
- Stroke Program, Edmonton Zone, Alberta Health Services, Edmonton, Canada
| | | | - Jocelyn Harris
- School of Rehabilitation Sciences, 3710McMaster University, Hamilton, Canada
| | - Esther Kim
- Department of Communication Sciences and Disorders, 3158University of Alberta, Edmonton, Canada
| | - Andrea Noland
- School of Audiology and Speech Sciences, University of British Columbia, Vancouver, Canada
| | - Sepideh Pooyania
- Physical Medicine and Rehabilitation, University of Manitoba, Winnipeg, Canada
| | - Annie Rochette
- School of Rehabilitation, University of Montreal, Montreal, Canada
| | | | - Erin Symcox
- Tertiary Neuro Rehabilitation, 26634Foothills Medical Centre, Calgary, Alberta
| | - Debbie Timpson
- Physical Medicine and Rehabilitation, 153197Pembroke Regional Hospital, Pembroke, Canada
| | - Suja Varghese
- Rehabilitation and Palliative Care Program, 102793Eastern Health, Newfoundland and Labrador, St. John's, Canada
| | - Sue Verrilli
- Northeastern Ontario Stroke Network, Sudbury, Canada
| | - Gord Gubitz
- Queen Elizabeth II Health Sciences Centre Stroke Program, Halifax, Canada
| | | | - Dar Dowlatshahi
- Faculty of Medicine, 6363University of Ottawa, Ottawa, Canada
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Affiliation(s)
- Catherine Lepage
- Occupational Therapy Program, School of Rehabilitation, University of Montreal, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
| | - Louis-Pierre Auger
- Occupational Therapy Program, School of Rehabilitation, University of Montreal, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
| | - Annie Rochette
- Occupational Therapy Program, School of Rehabilitation, University of Montreal, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
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Luconi F, Rochette A, Grad R, Hallé MC, Chin D, Habib B, Thomas A. A multifaceted continuing professional development intervention to move stroke rehabilitation guidelines into professional practice: A feasibility study. Top Stroke Rehabil 2020; 27:401-441. [PMID: 31960782 DOI: 10.1080/10749357.2019.1711339] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Rehabilitation post-stroke is critical for maximizing patient outcomes. This study assessed the feasibility of implementing and evaluating a continuing professional development (CPD) intervention aimed at increasing the uptake of stroke best practice guidelines among physiotherapists (PTs), occupational therapists (OTs) and speech-language pathologists (SLPs) in six university-affiliated stroke rehabilitation centers in Quebec, Canada. METHOD Twelve stroke best practice recommendations with reflective tools were sent weekly by e-mail. Participants' eligibility criteria included: a) profession; b) practicing more than 1 year in a stroke rehabilitation program; c) fluency in French or English; and d) basic computer literacy. Feasibility (operationalized via participation, satisfaction and relevance), cognitive impact, perceived application in practice and expected patient outcomes were measured over 24 weeks using three questionnaires and analyzed using descriptive statistics. RESULTS The sample totaled 62 of 133 eligible (47%) clinicians. Satisfaction, relevance and cognitive impact of delivered information varied across disciplines and recommendations. Agreement with the recommendations was high across disciplines. On average, three-interdisciplinary recommendations (related to post-stoke depression, post-stoke fatigue and patients' and caregivers' learning needs) were rated as the most relevant for at least one patient. The majority of clinicians would use the recommendations for a specific patient and expected health benefits by applying those recommendations. CONCLUSION This study demonstrated the feasibility of assessing the impact of a CPD intervention in stroke rehabilitation uptake and informed the design of a research program aimed at increasing the use of stroke evidence-based rehabilitation interventions.
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Affiliation(s)
- Francesca Luconi
- Continuing Professional Development (CPD), McGill University , Montreal, Quebec, Canada
| | - Annie Rochette
- CRIR - IUDPM, École de réadaptation, Université de Montréal , Montréal, Québec, Canada
| | - Roland Grad
- Department of Family Medicine, McGill University , Montréal, Québec, Canada
| | - Marie-Christine Hallé
- School of Physical and Occupational Therapy, McGill University , Montréal, Québec, Canada
| | - Diana Chin
- Chef d'administration de programme en réadaptation, CIUSSS Centre-Ouest-de-l'île-de-Montréal , Montréal, Québec, Canada
| | - Bettina Habib
- Continuing Professional Development, McGill University , Montréal, Québec, Canada
| | - Aliki Thomas
- School of Physical and Occupational Therapy, Centre for Medical Education, McGill University , Montréal, Québec, Canada
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Ouellet MA, Rochette A, Miéville C, Poissant L. Portrait of driving practice following a mild stroke: a secondary analysis of a chart audit. Top Stroke Rehabil 2019; 27:181-189. [DOI: 10.1080/10749357.2019.1684049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Marie-Andrée Ouellet
- Occupational Therapy Program, School of Rehabilitation, University of Montreal, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation in greater Montreal (CRIR), Montreal, Canada
| | - Annie Rochette
- Occupational Therapy Program, School of Rehabilitation, University of Montreal, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation in greater Montreal (CRIR), Montreal, Canada
| | - Carole Miéville
- Quebec Rehabilitation Research Network (REPAR), Montreal, Canada
| | - Lise Poissant
- Occupational Therapy Program, School of Rehabilitation, University of Montreal, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation in greater Montreal (CRIR), Montreal, Canada
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Loiselle F, Rochette A, Tétreault S, Lafortune M, Bastien J. Social circus program (Cirque du Soleil) promoting social participation of young people living with physical disabilities in transition to adulthood: a qualitative pilot study. Dev Neurorehabil 2019; 22:250-259. [PMID: 29842808 DOI: 10.1080/17518423.2018.1474502] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
PURPOSE To explore the perceived impact of a social circus program on the participation level of young adults' living with physical disabilities from their own and their parents' perspective. METHOD Exploratory phenomenological qualitative design. A social circus program was offered for nine months. Perceived participation level was documented through pre and post semi-structured interviews. A pretested interview guide was used. Interviews were transcribed and coded by two independent researchers. RESULTS The average age of the participants (n = 9) was 20.0 ± 1.4 years with 2/9 being female. Participation was perceived as being improved after the intervention from both perspectives (participants and parents) mainly for communication, mobility, relationships, community life and responsibilities. The intervention was perceived as strengthening self-perception and self-efficacy, which in turn enhanced participation level and decreased parents' bounding. CONCLUSION The results show promises for social circus as a new approach in adult physical rehabilitation for this population in transition.
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Affiliation(s)
- Frédéric Loiselle
- a École de réadaptation , Université de Montréal , Montreal , Canada.,b Centre de recherche interdisciplinaire en réadaptation de Montréal (CRIR) , Montreal , Canada.,c CIUSSS-Centre-Sud-de-l'Île-de-Montréal/Installation Centre de réadaptation Lucie-Bruneau (CRLB) , Montreal , Canada
| | - Annie Rochette
- a École de réadaptation , Université de Montréal , Montreal , Canada.,b Centre de recherche interdisciplinaire en réadaptation de Montréal (CRIR) , Montreal , Canada
| | - Sylvie Tétreault
- d Haute étude de travail social et de santé-EESP , Lausanne , Switzerland.,e Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS) , Quebec , Canada.,f Centre de réadaptation de l'Estrie (CRE) , Sherbrooke , Canada
| | - Michel Lafortune
- g Clinical psychologist , social circus program development consultant , Montreal , Canada
| | - Josée Bastien
- h Hôpital du Sacré-Cœur de Montréal , Montreal , Canada
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Beaudry L, Fortin S, Rochette A. Adapted dance used in subacute rehabilitation post-stroke: impacts perceived by patients, relatives and rehabilitation therapists. Disabil Rehabil 2019; 42:2997-3006. [PMID: 30907140 DOI: 10.1080/09638288.2019.1581845] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: To examine the perceived impacts of an adapted-dance group intervention when added to intensive functional rehabilitation post-stroke.Method: In this exploratory qualitative case study, semi-structured interviews were analyzed using a deliberative inductive logic and referring to the International Classification of Functioning, Disability and Health. Participants were patients in rehabilitation post-stroke (≤25 days) (n = 6), relatives (n = 4) and rehabilitation therapists (n = 12). Selection was on a voluntary basis. The intervention added to the patients' rehabilitation program consisted of 55-minute bi-weekly sessions for 10 weeks.Results: Three categories of perceived positive impacts emerged from the data: (1) mobility, (2) mental functions and personal factors (emotional functions, motivation and self-efficacy) and (3) interpersonal interactions and social life. A fourth category of perceived impacts involving exercise tolerance was both positive, in terms of general physical endurance, and negative, in terms of a feeling of increased fatigue.Conclusion: Such an adapted-dance intervention holds promise in subacute rehabilitation post-stroke. Its main strength lies in its perceived positive impact on mental functions, personal factors, and interpersonal and social interactions.Implications for rehabilitationAn adapted-dance group intervention could offer an innovative means of contributing to intensive functional rehabilitation post-stroke by potentially generating positive perceived impacts on emotional functions, motivation and self-efficacy, as well as on interpersonal and social interactions.Adapted dance could be added to inpatients' rehabilitation with only minor impacts on fatigue.
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Affiliation(s)
- Lucie Beaudry
- Department of Dance, Université du Québec à Montréal, Montréal,Canada.,Centre for Interdisciplinary Research in Rehabilitation (CRIR) of Greater Montreal, Montréal,Canada
| | - Sylvie Fortin
- Department of Dance, Université du Québec à Montréal, Montréal,Canada
| | - Annie Rochette
- Centre for Interdisciplinary Research in Rehabilitation (CRIR) of Greater Montreal, Montréal,Canada.,School of Rehabilitation, Université de Montréal, Montréal,Canada
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Al Zoubi F, Mayo N, Rochette A, Thomas A. Applying modern measurement approaches to constructs relevant to evidence-based practice among Canadian physical and occupational therapists. Implement Sci 2018; 13:152. [PMID: 30563550 PMCID: PMC6299597 DOI: 10.1186/s13012-018-0844-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 11/28/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Evidence-based practice (EBP) is a complex process. To quantify it, one has to also consider individual and contextual factors using multiple measures. Modern measurement approaches are available to optimize the measurement of complex constructs. This study aimed to develop a robust measurement approach for constructs around EBP including practice, individual (e.g. knowledge, attitudes, confidence, behaviours), and contextual factors (e.g. resources). METHODS One hundred eighty-one items arising from 5 validated EBP measures were subjected to an item analysis. Nominal group technique was used to arrive at a consensus about the content relevance of each item. Baseline questionnaire responses from a longitudinal study of the evolution of EBP in 128 new graduates of Canadian physical and occupational therapy programmes were analysed. Principles of Rasch Measurement Theory were applied to identify challenges with threshold ordering, item and person fit to the Rasch model, unidimensionality, local independence, and differential item functioning (DIF). RESULTS The nominal group technique identified 70/181 items, and modified Delphi approach identified 68 items that fit a formative model (2 related EBP domains: self-use of EBP (9 items) and EBP activities (7 items)) or a reflective model (4 related EBP domains: attitudes towards EBP (17 items), self-efficacy (9 items), knowledge (11 items) and resources (15 items)). Rasch analysis provided a single score for reflective construct. Among attitudes items, 65% (11/17) fit the Rasch model, item difficulties ranged from - 7.51 to logits (least difficult) to + 5.04 logits (most difficult), and person separation index (PSI) = 0.63. Among self-efficacy items, 89% (8/9) fit the Rasch model, item difficulties ranged from - 3.70 to + 4.91, and PSI = 0.80. Among knowledge items, 82% (9/11) fit the Rasch model, item difficulties ranged from - 7.85 to 4.50, and PSI = 0.81. Among resources items, 87% (13/15) fit the Rasch model, item difficulties ranged from - 3.38 to 2.86, and PSI = 0.86. DIF occurred in 2 constructs: attitudes (1 by profession and 2 by language) and knowledge (1 by language and 2 by profession) arising from poor wording in the original version leading to poor translation. CONCLUSIONS Rasch Measurement Theory was applied to develop a valid and reliable measure of EBP. Further modifications to the items can be done for subsequent waves of the survey.
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Affiliation(s)
- Fadi Al Zoubi
- McGill University, Montreal, QC, Canada.
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada.
| | - Nancy Mayo
- McGill University, Montreal, QC, Canada
- Center for Outcomes Research and Evaluation (CORE), Research Institute of McGill University Health Center, Montreal, QC, Canada
| | - Annie Rochette
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
- Université de Montréal, Montreal, QC, Canada
| | - Aliki Thomas
- McGill University, Montreal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
- Centre for Medical Education, Montreal, Canada
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Hallé MC, Mylopoulos M, Rochette A, Vachon B, Menon A, McCluskey A, Amari F, Thomas A. Attributes of evidence-based occupational therapists in stroke rehabilitation. Can J Occup Ther 2018; 85:351-364. [PMID: 30453765 DOI: 10.1177/0008417418802600] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND. A better understanding of the features characterizing expert evidence-based occupational therapists in stroke rehabilitation is needed to inform the design of educational and knowledge translation interventions aimed at addressing research-practice gaps. PURPOSE. The study aimed to identify the attributes of evidence-based occupational therapy stroke rehabilitation experts from the perspective of their peers. METHOD. Forty-six occupational therapy clinicians and managers completed an online questionnaire asking them to nominate "outstanding" and "expert evidence-based" occupational therapists in stroke rehabilitation and to explain their choices. A thematic analysis of respondents' statements was conducted. FINDINGS. Both outstanding and expert evidence-based occupational therapists were perceived to be motivated self-learners; to have extensive knowledge, skills, and experience; to act as scholarly practitioners; to achieve superior client outcomes; and to work in specialized settings. IMPLICATIONS. The development of future strategies supporting occupational therapy students and clinicians to become lifelong learners should take into account key attributes of expertise, such as motivation for continuous learning and professional development.
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Rochette A, Malenfant Rancourt MP, Sola C, Prodhomme O, Saguintaah M, Schaub R, Molinari N, Capdevila X, Dadure C. Cerebrospinal fluid volume in neonates undergoing spinal anaesthesia: a descriptive magnetic resonance imaging study. Br J Anaesth 2018; 117:214-9. [PMID: 27440633 DOI: 10.1093/bja/aew185] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Spinal anaesthesia (SA) reduces the risk of postoperative apnoea after general anaesthesia in neonates. In 30% of patients, however, the duration of anaesthesia provided does not allow completion of surgery. When compared with term infants, formerly preterm neonates experience a shorter duration of anaesthesia after SA. A difference in the cerebrospinal fluid (CSF) volume between those two populations could explain this difference, but this has never been investigated. The study was designed to evaluate the relationship between the spinal CSF volume and patient characteristics in neonates. METHODS Sixty-seven neonates, aged 30-60 weeks postconception, were included in this study. Their spinal CSF volumes were calculated using magnetic resonance imaging, and these volumes were plotted individually against sex, term at birth, birth weight, current gestational age, civil age, and weight. Correlations between CSF volume and these variables were investigated. RESULTS Fifty-four neonates completed the study. The CSF volume was found to be closely and linearly correlated with weight and postconceptional age. The relationship between spinal CSF volume and weight can be described as follows: CSF volume (ml)=1.94 weight (kg)+0.13. The CSF volume was not correlated with sex, weight, or term at birth, nor with civil age. CONCLUSIONS The amount of spinal CSF in neonates can be estimated as 2 ml kg(-1) in both term and formerly preterm neonates. A difference in the CSF volume between them does not provide an explanation for a shorter duration of SA in the latter. Our findings reinforce weight-adjusted dosage of SA in neonates.
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Affiliation(s)
- A Rochette
- Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France
| | - M-P Malenfant Rancourt
- Department of Anesthesia, McGill University Health Center, Montreal Children's Hospital, Montreal, Quebec, Canada
| | - C Sola
- Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France
| | - O Prodhomme
- Department of Pediatric Radiology, Arnaud de Villeneuve University Hospital, CHU de Montpellier, France
| | - M Saguintaah
- Department of Pediatric Radiology, Arnaud de Villeneuve University Hospital, CHU de Montpellier, France
| | - R Schaub
- Department of Medical Information, UMR 1044, CHU de Montpellier, France
| | - N Molinari
- Department of Medical Information, UMR 1044, CHU de Montpellier, France
| | - X Capdevila
- Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France
| | - C Dadure
- Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France
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Esmail A, Poncet F, Rochette A, Auger C, Billebaud C, de Guise É, Ducharme I, Kehayia E, Labbé D, Dahan-Oliel N, Lessard I, Vermeersch O, Swaine B. The role of clothing in participation of persons with a physical disability: a scoping review protocol. BMJ Open 2018; 8:e020299. [PMID: 29523570 PMCID: PMC5855208 DOI: 10.1136/bmjopen-2017-020299] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Clothing is an important aspect of nearly all human societies from performing social and cultural functions to indicating social status, a form of protection and a way for self-expression. It can help or hinder the ability to fulfil everyday activities and social roles and with the rising industry of wearable technologies, smart textiles are adding health-monitoring functions to clothing. The influence that clothing can have on the life of someone with a physical disability is significant, and further research is needed to understand it better. To achieve this, a scoping review will be performed with the aim of understanding the role of clothing in participation (ie, at home, in the community, etc) of individuals with a physical disability. This article presents the protocol and procedure to be adopted. METHODS AND ANALYSIS An in-depth iterative analysis of the scientific literature from six databases (MEDLINE, Embase, CINAHL, Scopus, PsycINFO and ERIC) as well as a hand search of grey literature and reference lists will be performed. After an abstract and full-text review of references by three reviewers independently, data from the selected articles will be tabulated and synthesised with a qualitative and quantitative approach using the International Classification of Functioning, Disability and Health as a unifying conceptual framework. A multidisciplinary consultation group of experts from various stakeholder groups will be involved in multiple steps to ensure validation and relevance of the data. ETHICS AND DISSEMINATION As this is a review involving analysis of data available in the public domain and does not involve human participants, ethical approval was not required. Results will be presented in a co-constructed format with the expert consultation group to ensure validity and maximise its practicality moving forward. Our dissemination plan includes peer-reviewed publications, presentations and stakeholder meetings.
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Affiliation(s)
- Alida Esmail
- École de réadaptation, Faculté de Médecine, Université de Montréal, Montreal, Quebec, Canada
- Lucie-Bruneau Rehabilitation Center, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada
| | - Frédérique Poncet
- Department of Psychology, Concordia University, Montreal, Quebec, Canada
- Institut Nazareth et Louis-Braille, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada
| | - Annie Rochette
- École de réadaptation, Faculté de Médecine, Université de Montréal, Montreal, Quebec, Canada
- Lucie-Bruneau Rehabilitation Center, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada
| | - Claudine Auger
- École de réadaptation, Faculté de Médecine, Université de Montréal, Montreal, Quebec, Canada
- Lucie-Bruneau Rehabilitation Center, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada
| | - Christophe Billebaud
- Rhizome Strategies, Montreal, Quebec, Canada
- La Piscine, Montreal, Quebec, Canada
| | - Élaine de Guise
- Lucie-Bruneau Rehabilitation Center, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada
- Département de psychologie, Université de Montréal, Montreal, Quebec, Canada
| | | | - Eva Kehayia
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Jewish Rehabilitation Hospital, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada
| | - Delphine Labbé
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Noémi Dahan-Oliel
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Shriners Hospitals for Children-Canada, Montreal, Quebec, Canada
| | | | | | - Bonnie Swaine
- École de réadaptation, Faculté de Médecine, Université de Montréal, Montreal, Quebec, Canada
- Lucie-Bruneau Rehabilitation Center, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada
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Vachon B, Foucault ML, Giguère CÉ, Rochette A, Thomas A, Morel M. Factors Influencing Acceptability and Perceived Impacts of a Mandatory ePortfolio Implemented by an Occupational Therapy Regulatory Organization. J Contin Educ Health Prof 2018; 38:25-31. [PMID: 29261571 DOI: 10.1097/ceh.0000000000000182] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION The use of ePortfolios has been implemented in several regulatory organizations to encourage clinicians' engagement in continuing professional development (CPD). However, their use has achieved mixed success, and multiple personal and contextual factors can influence their impacts on practice change. The aim of this study was to identify which factors influence the acceptability and perceived impacts of an ePortfolio implemented by an occupational therapy regulatory organization in one Canadian province. METHOD A cross-sectional online survey design was used. The survey was sent to registered occupational therapists in Quebec. Multiple regression analyses were conducted to identify factors influencing acceptability and outcomes: ease of use, satisfaction, impact on implementation of the CPD plan, and competence improvement. RESULTS The survey was fully completed by 546 participants. Factors significantly influencing the ePortfolio acceptability and perceived impacts were attitude toward and familiarity with the portfolio, confidence in reflective skills, engagement in the CPD plan, and desire for feedback. Time spent completing the ePortfolio and the fact of completing it in teams were negatively associated with the outcomes. DISCUSSION Shaping more favorable user attitudes, helping users recognize and experience the tool's benefits for their practice, and fostering confidence in their reflective skills are important factors that can be addressed to improve ePortfolio acceptability and outcomes. Contextual factors, such as time spent completing the ePortfolio and completing it in teams, seem to reflect greater difficulty with using the tool. Study findings can contribute to improving ePortfolio implementation in the CPD context.
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Affiliation(s)
- Brigitte Vachon
- Dr. Vachon: Associate Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal; Centre de Recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, Canada. Mrs. Foucault: School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada. Mr. Giguère: Centre de Recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, Canada. Dr. Rochette: Full Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal; Centre for Interdisciplinary Research in Rehabilitation of the Greater Montreal, Montreal, Canada. Dr. Thomas: Assistant Professor, School of Physical and Occupational Therapy, Centre for Medical Education, McGill University; Centre for Interdisciplinary Research in Rehabilitation of the Greater Montreal, Montreal, Canada. Ms. Morel: School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada
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Boufaied N, Nash C, Rochette A, Smith A, Orr B, Grace OC, Wang YC, Badescu D, Ragoussis J, Thomson AA. Identification of genes expressed in a mesenchymal subset regulating prostate organogenesis using tissue and single cell transcriptomics. Sci Rep 2017; 7:16385. [PMID: 29180763 PMCID: PMC5703996 DOI: 10.1038/s41598-017-16685-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 11/16/2017] [Indexed: 01/25/2023] Open
Abstract
Prostate organogenesis involves epithelial growth controlled by inductive signalling from specialised mesenchymal subsets. To identify pathways active in mesenchyme we used tissue and single cell transcriptomics to define mesenchymal subsets and subset-specific transcript expression. We documented transcript expression using Tag-seq and RNA-seq in female rat Ventral Mesenchymal Pad (VMP) as well as adjacent urethra comprised of smooth muscle and peri-urethral mesenchyme. Transcripts enriched in female VMP were identified with Tag-seq of microdissected tissue, RNA-seq of cell populations, and single cells. We identified 400 transcripts as enriched in the VMP using bio-informatic comparisons of Tag-seq and RNA-seq data, and 44 were confirmed by single cell RNA-seq. Cell subset analysis showed that VMP and adjacent mesenchyme were composed of distinct cell types and that each tissue contained two subgroups. Markers for these subgroups were highly subset specific. Thirteen transcripts were validated by qPCR to confirm cell specific expression in microdissected tissues, as well as expression in neonatal prostate. Immunohistochemical staining demonstrated that Ebf3 and Meis2 showed a restricted expression pattern in female VMP and prostate mesenchyme. We conclude that prostate inductive mesenchyme shows limited cellular heterogeneity and that transcriptomic analysis identified new mesenchymal subset transcripts associated with prostate organogenesis.
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Affiliation(s)
- Nadia Boufaied
- Department of Surgery, Division of Urology, Cancer Research Program, McGill University Health Centre, 1001 Decarie Boulevard, Montreal, Quebec, H4A 3J1, Canada
| | - Claire Nash
- Department of Surgery, Division of Urology, Cancer Research Program, McGill University Health Centre, 1001 Decarie Boulevard, Montreal, Quebec, H4A 3J1, Canada
| | - Annie Rochette
- Department of Surgery, Division of Urology, Cancer Research Program, McGill University Health Centre, 1001 Decarie Boulevard, Montreal, Quebec, H4A 3J1, Canada
| | - Anthony Smith
- Department of Surgery, Division of Urology, Cancer Research Program, McGill University Health Centre, 1001 Decarie Boulevard, Montreal, Quebec, H4A 3J1, Canada
| | - Brigid Orr
- MRC Human Reproductive Sciences Unit, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - O Cathal Grace
- MRC Human Reproductive Sciences Unit, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - Yu Chang Wang
- McGill University and Genome Quebec Innovation Centre, 740 Dr. Penfield Avenue, Montreal, H3A 0G1, Canada
| | - Dunarel Badescu
- McGill University and Genome Quebec Innovation Centre, 740 Dr. Penfield Avenue, Montreal, H3A 0G1, Canada
| | - Jiannis Ragoussis
- McGill University and Genome Quebec Innovation Centre, 740 Dr. Penfield Avenue, Montreal, H3A 0G1, Canada
| | - Axel A Thomson
- Department of Surgery, Division of Urology, Cancer Research Program, McGill University Health Centre, 1001 Decarie Boulevard, Montreal, Quebec, H4A 3J1, Canada.
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Léveillé A, Rochette A, Mainville C. Perceived risks and benefits of hippotherapy among parents of children currently engaged in or waiting for hippotherapy: A pilot study. Physiother Theory Pract 2017; 33:269-277. [DOI: 10.1080/09593985.2017.1302029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Foucault ML, Vachon B, Thomas A, Rochette A, Giguère CÉ. Utilisation of an electronic portfolio to engage rehabilitation professionals in continuing professional development: results of a provincial survey. Disabil Rehabil 2017; 40:1591-1599. [PMID: 28291951 DOI: 10.1080/09638288.2017.1300335] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION ePortfolios are frequently used to support continuing professional development (CPD) of rehabilitation professionals. Though this tool is now widely implemented in many professions by regulatory organisations, very few studies have investigated the use and impact among rehabilitation professionals. Implementation of comprehensive ePortfolios that are centred on the needs of rehabilitation professionals requires documenting their level of use and perceived outcomes. OBJECTIVES The objectives were to describe how occupational therapists use a mandatory ePortfolio that has been recently implemented by a regulatory organisation in Quebec (Canada) and the perceived outcomes of this requirement on continuing professional development and practice change. METHODS An online survey was sent to all registered occupational therapists in Quebec using the ePortfolio. The survey content was developed based on a literature review and expert consultation. Results were analysed using descriptive statistics. RESULTS A total of 546 respondents completed the survey. Results show relatively high levels of ease and satisfaction with the tool, but a limited perception of the tool's impacts on the improvement of professional competencies and change in practices. CONCLUSIONS Occupational therapists reported that use of the ePortfolio supports their engagement in CPD but has limited impact on practice. Promotion of work-based learning, team use and mentor support could increase its meaningfulness for professionals. Implications for Rehabilitation To improve attitudes and beliefs about benefits related to portfolio use, rehabilitation practitioners need a very clear understanding of the purpose and usefulness of a portfolio in clinical practice. Most of the respondents saw the ePortfolio as helping them develop and implement a continuing professional development plan and reflect on the changes needed in their practice. Portfolio use in teams and productive reflection should be promoted in order to target shared objectives for continuous practice improvement. Rehabilitation professionals trained in portfolio use during their entry-level studies have a slightly more positive attitude towards portfolio use and impact of this use compared with than clinicians who have not had this training.
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Affiliation(s)
- Marie-Lyse Foucault
- a School of rehabilitation, Faculty of Medicine , Université de Montréal , Montreal , Canada
| | - Brigitte Vachon
- a School of rehabilitation, Faculty of Medicine , Université de Montréal , Montreal , Canada.,b Centre de recherche de l'Institut universitaire en santé mentale de Montréal , Montreal , Canada
| | - Aliki Thomas
- c School of Physical and Occupational Therapy , Centre for Medical Education, McGill University , Montreal , Canada.,d Centre for Interdisciplinary Research in Rehabilitation of the Greater Montreal , Montreal , Canada
| | - Annie Rochette
- a School of rehabilitation, Faculty of Medicine , Université de Montréal , Montreal , Canada.,d Centre for Interdisciplinary Research in Rehabilitation of the Greater Montreal , Montreal , Canada
| | - Charles-Édouard Giguère
- b Centre de recherche de l'Institut universitaire en santé mentale de Montréal , Montreal , Canada
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Rochette A, Boufaied N, Scarlata E, Hamel L, Brimo F, Whitaker HC, Ramos-Montoya A, Neal DE, Dragomir A, Aprikian A, Chevalier S, Thomson AA. Asporin is a stromally expressed marker associated with prostate cancer progression. Br J Cancer 2017; 116:775-784. [PMID: 28152543 PMCID: PMC5355923 DOI: 10.1038/bjc.2017.15] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 12/23/2016] [Accepted: 01/05/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Prostate cancer shows considerable heterogeneity in disease progression and we propose that markers expressed in tumour stroma may be reliable predictors of aggressive tumour subtypes. METHODS We have used Kaplan-Meier, univariate and multivariate analysis to correlate the expression of Asporin (ASPN) mRNA and protein with prostate cancer progression in independent cohorts. We used immunohistochemistry and H scoring to document stromal localisation of ASPN in a tissue microarray and mouse prostate cancer model, and correlated expression with reactive stroma, defined using Masson Trichrome staining. We used cell cultures of primary prostate cancer fibroblasts treated with serum-free conditioned media from prostate cancer cell lines to examine regulation of ASPN mRNA in tumour stromal cells. RESULTS We observed increased expression of ASPN mRNA in a data set derived from benign vs tumour microdissected tissue, and a correlation with biochemical recurrence using Kaplan-Meier and Cox proportional hazard analysis. ASPN protein localised to tumour stroma and elevated expression of ASPN was correlated with decreased time to biochemical recurrence, in a cohort of 326 patients with a median follow up of 9.6 years. Univariate and multivariate analysis demonstrated that ASPN was correlated with progression, as were Gleason score, and clinical stage. Additionally, ASPN expression correlated with the presence of reactive stroma, suggesting that it may be a stromal marker expressed in response to the presence of tumour cells and particularly with aggressive tumour subtypes. We observed expression of ASPN in the stroma of tumours induced by p53 inhibition in a mouse model of prostate cancer, and correlation with neuroendocrine marker expression. Finally, we demonstrated that ASPN transcript expression in normal and cancer fibroblasts was regulated by conditioned media derived from the PC3, but not LNCaP, prostate cancer cell lines. CONCLUSIONS Our results suggest that ASPN is a stromally expressed biomarker that correlates with disease progression, and is observed in reactive stroma. ASPN expression in stroma may be part of a stromal response to aggressive tumour subtypes.
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Affiliation(s)
- Annie Rochette
- Department of Surgery, Division of Urology, McGill University and the Cancer Research Program of the Research Institute of McGill University Health Centre, Montreal, Quebec H4A 3J1, Canada
| | - Nadia Boufaied
- Department of Surgery, Division of Urology, McGill University and the Cancer Research Program of the Research Institute of McGill University Health Centre, Montreal, Quebec H4A 3J1, Canada
| | - Eleonora Scarlata
- Department of Surgery, Division of Urology, McGill University and the Cancer Research Program of the Research Institute of McGill University Health Centre, Montreal, Quebec H4A 3J1, Canada
| | - Lucie Hamel
- Department of Surgery, Division of Urology, McGill University and the Cancer Research Program of the Research Institute of McGill University Health Centre, Montreal, Quebec H4A 3J1, Canada
| | - Fadi Brimo
- Department of Pathology, Division of Urology, McGill University and The McGill University Health Centre, Montreal, Quebec H4A 3J1, Canada
| | - Hayley C Whitaker
- Department of Oncology, University of Cambridge, Box 279, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ, UK
| | - Antonio Ramos-Montoya
- Department of Oncology, University of Cambridge, Box 279, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ, UK
| | - David E Neal
- Department of Oncology, University of Cambridge, Box 279, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ, UK
| | - Alice Dragomir
- Department of Surgery, Division of Urology, McGill University and the Cancer Research Program of the Research Institute of McGill University Health Centre, Montreal, Quebec H4A 3J1, Canada
| | - Armen Aprikian
- Department of Surgery, Division of Urology, McGill University and the Cancer Research Program of the Research Institute of McGill University Health Centre, Montreal, Quebec H4A 3J1, Canada
| | - Simone Chevalier
- Department of Surgery, Division of Urology, McGill University and the Cancer Research Program of the Research Institute of McGill University Health Centre, Montreal, Quebec H4A 3J1, Canada
| | - Axel A Thomson
- Department of Surgery, Division of Urology, McGill University and the Cancer Research Program of the Research Institute of McGill University Health Centre, Montreal, Quebec H4A 3J1, Canada
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Labbé D, Poldma T, Fichten C, Havel A, Kehayia E, Mazer B, McKinley P, Rochette A, Swaine B. Rehabilitation in the real-life environment of a shopping mall. Disabil Rehabil 2017; 40:848-855. [PMID: 28129514 DOI: 10.1080/09638288.2016.1277394] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIM The aim of this study was to explore how shopping malls could be used during rehabilitation and to identify the facilitators and barriers to their use. METHOD Two focus groups, conducted with 15 rehabilitation professionals from various disciplines and working with people with disabilities of all ages were structured around two topics: (i) The usage of malls for rehabilitation and (ii) Factors that facilitate or limit rehabilitation professionals' use of the mall as an environment for clinical assessment and/or intervention. RESULTS The thematic analysis revealed that shopping malls were used to achieve several rehabilitation goals targeting physical and cognitive skills, psychological health and socialization. This real-life environment is motivating and helps foster independence and normalization. Factors affecting mall use during rehabilitation included personal factors (e.g. clients' personality and level of readiness) and environmental factors (e.g. clinical context, accessibility of the mall and social attitudes of store owners). CONCLUSION Shopping malls may be a relevant rehabilitation assessment and treatment environment that could contribute to optimizing community integration of people with disabilities. Implications for rehabilitation To ensure successful community reintegration, clients could be trained at some point during their rehabilitation, to perform activities in real-life settings, such as a shopping mall. Shopping malls appear to enable the attainment of rehabilitation goals targeting a variety of skills. This real-life environment appears to be motivating and helps foster independence and normalization. Factors felt to affect mall use during rehabilitation include personal factors (e.g. clients' personality and level of readiness) and environmental factors (e.g. clinical context, accessibility of the mall and social attitudes of store owners). The shopping mall may be an untapped resource as it appears to be a relevant rehabilitation assessment and treatment environment that could contribute to optimizing community integration of people with disabilities.
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Affiliation(s)
- Delphine Labbé
- a Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR) , Montréal , Canada.,b Department of Psychology , Université de Québec à Montréal , Montréal , Canada
| | - Tiiu Poldma
- a Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR) , Montréal , Canada.,c Faculté de l'Aménagement , Université de Montréal , Montréal , Canada
| | - Catherine Fichten
- a Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR) , Montréal , Canada.,d Adaptech Research Network , Montréal , Canada.,e Department of Psychiatry , McGill University , Montréal , Canada
| | - Alice Havel
- d Adaptech Research Network , Montréal , Canada
| | - Eva Kehayia
- a Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR) , Montréal , Canada.,f School of Physical and Occupational Therapy, McGill University , Montréal , Canada
| | - Barbara Mazer
- a Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR) , Montréal , Canada.,f School of Physical and Occupational Therapy, McGill University , Montréal , Canada
| | - Patricia McKinley
- a Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR) , Montréal , Canada.,f School of Physical and Occupational Therapy, McGill University , Montréal , Canada
| | - Annie Rochette
- a Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR) , Montréal , Canada.,g École de réadaptation, Université de Montréal , Montréal , Canada
| | - Bonnie Swaine
- a Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR) , Montréal , Canada.,g École de réadaptation, Université de Montréal , Montréal , Canada
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Desrosiers J, Rochette A, Hébert R, Bravo G. The Minnesota Manual Dexterity Test: Reliability, Validity and Reference Values Studies with Healthy Elderly People. Can J Occup Ther 2016. [DOI: 10.1177/000841749706400504] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Several dexterity tests have been developed, including the Minnesota Rate of Manipulation Test (MRMT) and a new version, the Minnesota Manual Dexterity Test (MMDT). The objectives of the study were: a) to verify the test-retest reliability of the MMDT; b) to compare the MRMT and the MMDT; c) to study the concurrent validity of the MMDT; and d) to establish reference values for elderly people with the MMDT. Two hundred and forty-seven community-living healthy elderly were evaluated with the MMDT, and two other dexterity tests, the Box and Block Test (BBT) and the Purdue Pegboard (PP). Thirty-five of them were evaluated twice with the MMDT and 44 were evaluated with both the MMDT and MRMT. The results show that the test-retest reliability of the MMDT is acceptable to high (intraclass correlation coefficients of 0.79 to 0.87, depending on the subtest) and the validity of the test is demonstrated by significant correlations between the MMDT, the BBT and the PP (0.63 to 0.67). There is a high correlation (0.85 to 0.95) between the MMDT and the MMRT in spite of different results. The reference values will help occupational therapists to differentiate better between real dexterity difficulties and those that may be attributed to normal aging.
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Hebert D, Lindsay MP, McIntyre A, Kirton A, Rumney PG, Bagg S, Bayley M, Dowlatshahi D, Dukelow S, Garnhum M, Glasser E, Halabi ML, Kang E, MacKay-Lyons M, Martino R, Rochette A, Rowe S, Salbach N, Semenko B, Stack B, Swinton L, Weber V, Mayer M, Verrilli S, DeVeber G, Andersen J, Barlow K, Cassidy C, Dilenge ME, Fehlings D, Hung R, Iruthayarajah J, Lenz L, Majnemer A, Purtzki J, Rafay M, Sonnenberg LK, Townley A, Janzen S, Foley N, Teasell R. Canadian stroke best practice recommendations: Stroke rehabilitation practice guidelines, update 2015. Int J Stroke 2016; 11:459-84. [DOI: 10.1177/1747493016643553] [Citation(s) in RCA: 342] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Accepted: 03/08/2016] [Indexed: 11/17/2022]
Abstract
Stroke rehabilitation is a progressive, dynamic, goal-orientated process aimed at enabling a person with impairment to reach their optimal physical, cognitive, emotional, communicative, social and/or functional activity level. After a stroke, patients often continue to require rehabilitation for persistent deficits related to spasticity, upper and lower extremity dysfunction, shoulder and central pain, mobility/gait, dysphagia, vision, and communication. Each year in Canada 62,000 people experience a stroke. Among stroke survivors, over 6500 individuals access in-patient stroke rehabilitation and stay a median of 30 days (inter-quartile range 19 to 45 days). The 2015 update of the Canadian Stroke Best Practice Recommendations: Stroke Rehabilitation Practice Guidelines is a comprehensive summary of current evidence-based recommendations for all members of multidisciplinary teams working in a range of settings, who provide care to patients following stroke. These recommendations have been developed to address both the organization of stroke rehabilitation within a system of care (i.e., Initial Rehabilitation Assessment; Stroke Rehabilitation Units; Stroke Rehabilitation Teams; Delivery; Outpatient and Community-Based Rehabilitation), and specific interventions and management in stroke recovery and direct clinical care (i.e., Upper Extremity Dysfunction; Lower Extremity Dysfunction; Dysphagia and Malnutrition; Visual-Perceptual Deficits; Central Pain; Communication; Life Roles). In addition, stroke happens at any age, and therefore a new section has been added to the 2015 update to highlight components of stroke rehabilitation for children who have experienced a stroke, either prenatally, as a newborn, or during childhood. All recommendations have been assigned a level of evidence which reflects the strength and quality of current research evidence available to support the recommendation. The updated Rehabilitation Clinical Practice Guidelines feature several additions that reflect new research areas and stronger evidence for already existing recommendations. It is anticipated that these guidelines will provide direction and standardization for patients, families/caregiver(s), and clinicians within Canada and internationally.
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Affiliation(s)
- Debbie Hebert
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - M Patrice Lindsay
- University of Toronto, Toronto, Ontario, Canada
- Heart and Stroke Foundation Canada, Ottawa, Canada
| | - Amanda McIntyre
- St. Joseph's Healthcare – Parkwood Institute, London, ON, Canada
- Lawson Health Research Institute, London, ON, Canada
| | - Adam Kirton
- Calgary Paediatric Stroke Program, Department of Paediatrics, University of Calgary, Calgary, Canada
- University of Calgary, Calgary, Canada
| | - Peter G Rumney
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | | | - Mark Bayley
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | | | | | - Maridee Garnhum
- Queen Elizabeth Hospital, Charlottetown, Prince Edward Island, Canada
| | - Ev Glasser
- Heart and Stroke Foundation Canada, Ottawa, Canada
| | - Mary-Lou Halabi
- Alberta Health Services, Stroke Program, Edmonton Zone, Edmonton, Canada
| | - Ester Kang
- Saskatoon Health Region, Saskatchewan, Canada
| | | | | | | | - Sarah Rowe
- GF Strong Rehabilitation Centre, Vancouver, British Columbia, Canada
| | | | - Brenda Semenko
- Health Sciences Centre, University of Manitoba, Manitoba, Canada
| | | | - Luchie Swinton
- Cardiovascular Health & Stroke Strategic Clinical Network, Alberta Health Services, Alberta, Canada
| | | | | | - Sue Verrilli
- Northeastern Ontario Stroke Network, Ontario, Canada
| | - Gabrielle DeVeber
- University of Toronto, Toronto, Ontario, Canada
- Hospital for Sick Children, Toronto, Ontario, Canada
| | - John Andersen
- Glenrose Rehabilitation Hospital, University of Alberta, Alberta, Canada
| | - Karen Barlow
- University of Calgary, Calgary, Canada
- Alberta Children’s Hospital, Calgary, Alberta, Canada
| | - Caitlin Cassidy
- St. Joseph's Healthcare – Parkwood Institute, London, ON, Canada
| | | | - Darcy Fehlings
- University of Toronto, Toronto, Ontario, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Ryan Hung
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | | | - Laura Lenz
- Canadian Paediatric Stroke Support Association, Ontario, Canada
| | - Annette Majnemer
- Montreal Children’s Hospital, Montreal, Canada
- McGill University, Montreal, Canada
| | - Jacqueline Purtzki
- BC Children’s Hospital, Vancouver, British Columbia, Canada
- Faculty of Medicine, University of British Columbia, Canada
| | - Mubeen Rafay
- Children’s Hospital, University of Manitoba, Manitoba, Canada
| | - Lyn K. Sonnenberg
- Glenrose Rehabilitation Hospital, University of Alberta, Alberta, Canada
- Stollery Children’s Hospital, Edmonton, Canada
| | | | - Shannon Janzen
- St. Joseph's Healthcare – Parkwood Institute, London, ON, Canada
| | - Norine Foley
- workHORSE Consulting Limited, London, Ontario, Canada
- Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Robert Teasell
- St. Joseph's Healthcare – Parkwood Institute, London, ON, Canada
- Lawson Health Research Institute, London, ON, Canada
- Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
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Rochette A, Gaulin P, Chamelian L, Hebert L, Lapierre M, Deschaintre Y. Circumstances surrounding the onset of stroke: a qualitative study. J Adv Nurs 2015; 72:641-9. [PMID: 26586146 DOI: 10.1111/jan.12858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2015] [Indexed: 11/28/2022]
Abstract
AIM To document perceptions of circumstances spontaneously associated with the occurrence of the stroke on that particular day. BACKGROUND Known triggers of stroke include birthday or negative emotions. However, specific circumstances relating to that birthday or emotion have not yet been documented. DESIGN Phenomenological perspective where data were collected between October 2011-June 2012. METHOD In-depth interviews conducted 5-8 weeks post stroke with 37 participants, with a mean age of 56·3 years (sd 11·9) and 40·5% (14/37) of whom were female. An interview guide composed of open-ended questions and developed with experts was used to explore in detail free associations surrounding the stroke. All interviews were audiotaped and transcribed. Data were rigorously analysed by two team members and discussed in team meetings until reaching consensus on essential themes. FINDINGS Relationships emerged as being the overarching theme related to stroke triggers with the interrelated subthemes of: (1) birthday or anniversary; (2) parenting; (3) being sick seen as a benefit; and (4) alcohol or drug abuse. The stroke happened on a day which was related in some way to a relationship with a significant other affected by tension, a lack of transparency or an overinvestment of emotional/affective state. CONCLUSIONS There is a need to address individuals' beliefs as a part of secondary prevention interventions to be truly client-centred, which the phenomenological perspective allows. Relationships as a potential source of stress should be added as a theme to discuss with patients for a holistic approach to stroke prevention including psychosocial factors.
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Affiliation(s)
- Annie Rochette
- Montreal University, Quebec, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Quebec, Canada
| | - Philippe Gaulin
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Quebec, Canada
| | - Laury Chamelian
- Montreal University, Quebec, Canada.,Centre Hospitalier de l'Université de Montréal, Notre-Dame, Quebec, Canada
| | - Lucie Hebert
- Montreal University, Quebec, Canada.,Centre Hospitalier de l'Université de Montréal, Notre-Dame, Quebec, Canada
| | - Marlene Lapierre
- Centre Hospitalier de l'Université de Montréal, Notre-Dame, Quebec, Canada
| | - Yan Deschaintre
- Montreal University, Quebec, Canada.,Centre Hospitalier de l'Université de Montréal, Notre-Dame, Quebec, Canada
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50
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Baillargeon-Normand F, Rochette A, Gaulin P. Circumstances surrounding stroke onset: symbolic meaning of time factors related to numbers and days of the week. Disabil Rehabil 2015; 38:282-8. [PMID: 25909958 DOI: 10.3109/09638288.2015.1038366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To explore the circumstances surrounding the onset of stroke, and especially the symbolic meaning of time factors related to numbers and days of the week. METHOD Phenomenological qualitative study involving individual interviews conducted 5-8 weeks post-stroke. The audiotaped interviews were transcribed, then comprehensively coded by two team members, and summaries of each case were written. Since this was a secondary analysis, special attention was paid to the significance of themes, numbers and days of the week when analyzing the summaries and transcripts. RESULTS Interviews were conducted with 37 participants (mean age 56.3 ± 11.9 years, 60% male). Five themes were identified with respect to the meaning attributed to numbers: (1) personal events, (2) historical events, (3) annual events, (4) age, and (5) avoidance. Themes identified as being associated with days of the week were work, leisure activities, household chores and medical tests/appointments. CONCLUSION The impact of internalised emotions related to these perceptions can be quite significant. This study suggests that health professionals should personalise the secondary prevention of strokes by considering clients holistically and also give clients the opportunity to freely express their feelings about the meaning of time factors to foster awareness of their own perceptions. IMPLICATIONS FOR REHABILITATION The use of checklists only for stroke secondary prevention does not allow taking into account psychosocial factors as potential precipitating factors. An open dialogue about personal circumstances starting on the date and day the stroke happened enabled the emergence of meaningful themes. As relationships emerged as the overarching essential theme, quality of relationships could be addressed in rehabilitation post-stroke and thus potentially contribute to prevent stroke recurrence.
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Affiliation(s)
- Fanny Baillargeon-Normand
- a School of Rehabilitation , Montreal University , Quebec , Canada and.,b Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR) , Quebec , Canada
| | - Annie Rochette
- a School of Rehabilitation , Montreal University , Quebec , Canada and.,b Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR) , Quebec , Canada
| | - Philippe Gaulin
- b Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR) , Quebec , Canada
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