1
|
Cesca N, Lin C, Abu-Jurji Z, Wexler A, Mark J, McCullum S, Kamran R, Chan B, Musselman KE. Exploring knowledge and implementation gaps of activity-based therapy in centers lacking specialized spinal cord injury services: understanding therapists' perspectives. Spinal Cord Ser Cases 2024; 10:14. [PMID: 38514640 PMCID: PMC10957876 DOI: 10.1038/s41394-024-00619-4] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 02/14/2024] [Accepted: 02/16/2024] [Indexed: 03/23/2024] Open
Abstract
STUDY DESIGN Qualitative exploratory OBJECTIVES: Rehabilitation following spinal cord injury (SCI) is a life-long process involving healthcare in a variety of settings, including facilities lacking SCI-specific services (i.e., non-SCI-specialized centers). Activity-based therapy (ABT) is a neurorestorative approach involving intensive, task-specific movement practice below the injury level. This study explored the existing knowledge, perceptions, and implementation of ABT among physical and occupational therapists working in non-SCI-specialized centers. SETTING Canadian hospitals and community clinics DESIGN/METHODS: Semi-structured interviews were conducted with Canadian therapists who worked at non-SCI-specialized centers and treated at least one patient with SCI within the last 18 months. The Theoretical Domains Framework was used to develop interview questions that queried therapists' experiences in delivering SCI rehabilitation, their understanding of ABT and experience with its implementation. Interviews were audio-recorded, transcribed verbatim and analyzed using interpretive description. RESULTS Four physical therapists and three occupational therapists, from diverse settings (i.e., acute care, inpatient rehabilitation, long-term care, outpatient rehabilitation, rural outpatient clinic) participated. Three themes were identified: (1) Available knowledge, resources and therapy time in non-SCI-specialized centers challenge ABT implementation, (2) How current therapy practices in non-SCI-specialized centers align with ABT and (3) Desire for ABT knowledge. Although participants were not familiar with the term ABT, it was identified that they were unknowingly incorporating some components of ABT into their practice. Participants expressed a keenness to learn more about ABT. CONCLUSION Current knowledge and implementation of ABT in non-SCI-specialized centers is limited. Tailoring ABT education to therapists at non-SCI-specialized centers may increase ABT implementation.
Collapse
Affiliation(s)
- Nicole Cesca
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada
| | - Chantal Lin
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Zeina Abu-Jurji
- Faculty of Health Sciences, Masters of Physiotherapy, McMaster University, Hamilton, ON, Canada
| | - Aaron Wexler
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jonas Mark
- First Steps Wellness Centre, Winnipeg, MB, Canada
| | - Shane McCullum
- Stan Cassidy Centre for Rehabilitation, Horizon Health Network, Fredericton, NB, Canada
| | - Rija Kamran
- Rehabilitation Science, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Brian Chan
- KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Kristin E Musselman
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada.
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
| |
Collapse
|
2
|
Coulter E, McQueen C, Abu-Jurji Z, Chan-Emery I, Rukavina M, Solecki R, Wojkowski S, Dhir J. Development and delivery of justice, equity, diversity, inclusion, and anti-oppression concepts in entry-level health professional education: a scoping review protocol. JBI Evid Synth 2023:02174543-990000000-00260. [PMID: 38165208 DOI: 10.11124/jbies-23-00223] [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: 01/03/2024]
Abstract
OBJECTIVE The objective of this scoping review is to identify the frameworks, guidelines, and models used to develop and deliver justice, equity, diversity, inclusion (JEDI), and anti-oppression (AO) principles in mandatory, entry-level health care professional program curricula (EHCPPC). A secondary objective will be to examine how these frameworks, guidelines, and models are used. INTRODUCTION Health inequities are perpetuated globally, as observed by the suboptimal quality of care and health outcomes among equity-deserving groups. An understanding of JEDI and AO concepts is necessary in health care settings to promote culturally safe and high-quality care; however, entry-level health care programs may lack adequate integration of content and/or delivery of these principles. This scoping review will summarize the international literature on frameworks, guidelines, and models used to develop and deliver JEDI and AO concepts in EHCPPC. INCLUSION CRITERIA This review will consider articles that discuss frameworks, models, or guidelines included in EHCPPC that guide the development and/or delivery of JEDI and AO principles in any country. Studies will be considered if they were published from 2015 to the present and are in English. All study designs will be considered for inclusion. METHODS This review will be conducted in accordance with the JBI methodology for scoping reviews. A search of MEDLINE (Ovid), Embase (Ovid), and CINAHL (EBSCOhost) will be conducted. Two or more independent reviewers will assess titles and abstracts, screen full-text studies, and extract data from included studies. Data from the included studies will be collated into tables or figures and described in a narrative summary. REVIEW REGISTRATION Open Science Framework osf.io/ewqf8.
Collapse
Affiliation(s)
- Emma Coulter
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | | | | | | | | | | | | | | |
Collapse
|
3
|
Mehta S, Ahrens J, Abu-Jurji Z, Marrocco SL, Upper R, Loh E, Cornell S, Wolfe DL. Feasibility of a virtual service delivery model to support physical activity engagement during the COVID-19 pandemic for those with spinal cord injury. J Spinal Cord Med 2021; 44:S256-S265. [PMID: 34779728 PMCID: PMC8604449 DOI: 10.1080/10790268.2021.1970885] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The current pandemic has reduced access to safe, monitored physical activity (PA) programs for persons with spinal cord injury (SCI). The use of telerehabilitation has the potential for continuing activity engagement without risking virus exposure. The present study evaluates the feasibility and efficacy of an online group-based PA program for persons with SCI. METHODS This preliminary pre-post study delivered an online group-based PA program to persons with SCI. The program consisted of 1-hour sessions twice weekly for six weeks. Online PA satisfaction questionnaires were assessed at post-treatment. Psychosocial subscales from the NeuroQOL-SF were assessed. RESULTS Participants were adult females between 3 and 32 years post-injury, 1 tetraplegic and 3 paraplegics (n = 4). All participants were highly satisfied with the online instruction, overall content, and videoconferencing platform. Participants stated that the online program was beneficial for their overall physical and psychosocial wellbeing. The program resulted in improvement in anxiety and satisfaction with social roles and activities. CONCLUSION The current pilot study demonstrates the acceptability and limited efficacy of an online PA program for those with SCI. The program resulted in improved overall perceived wellbeing and satisfaction with social roles and activities. These results have important implications for the clinical implementation of online PA programs in a hospital and community setting.
Collapse
Affiliation(s)
- Swati Mehta
- Parkwood Institute Research, Lawson Health Research Institute, LondonON, Canada,Department of Physical Medicine and Rehabilitation, Western University, LondonON, Canada,Correspondence to: Swati Mehta, Parkwood Research Institute, 550 Wellington Road South, London, ONN6C 0A7, Canada; Ph (519) 685 4292 x 42359.
| | - Jess Ahrens
- Parkwood Institute Research, Lawson Health Research Institute, LondonON, Canada
| | - Zeina Abu-Jurji
- Parkwood Institute Research, Lawson Health Research Institute, LondonON, Canada
| | | | - Randy Upper
- Parkwood Institute Research, Lawson Health Research Institute, LondonON, Canada
| | - Eldon Loh
- Parkwood Institute Research, Lawson Health Research Institute, LondonON, Canada,Department of Physical Medicine and Rehabilitation, Western University, LondonON, Canada
| | - Stephanie Cornell
- Parkwood Institute Research, Lawson Health Research Institute, LondonON, Canada,Parkwood Institute, St. Joseph’s Health Care London, LondonON, Canada
| | - Dalton L. Wolfe
- Parkwood Institute Research, Lawson Health Research Institute, LondonON, Canada,Department of Physical Medicine and Rehabilitation, Western University, LondonON, Canada
| |
Collapse
|