Occupational therapists' experiences in integrating a new intervention in collaboration with a researcher

Practitioner Engagement by Academic Researchers: A Scoping Review of Nursing, Midwifery, and Therapy Professions Literature

BACKGROUND

Engagement of frontline practitioners by academic researchers in the research process is believed to afford benefits toward closing the research practice gap. However, little is known about if and how academic researchers engage nurses, midwives, or therapists in research activities or if evidence supports these claims of positive impact.

METHOD

A scoping review was undertaken using the Arksey and O'Malley (2005) framework to identify the extent to which this phenomenon has been considered in the literature.

RESULTS

An iterative search carried out in CINAHL, Pubmed, Medline, and Embase retrieved 32 relevant papers published 2000 to 2017, with the majority from the last 2-years. Retained papers described or evaluated active engagement of a practitioner from nursing, midwifery, and therapy disciplines in at least one stage of a research project other than as a study participant. Engagement most often took place in one research activity with few examples of engagement throughout the research process. Limited use of theory and variations in terms used to describe practitioner engagement by researchers was observed. Subjective perspectives of practitioners' experiences and a focus on challenges and benefits were the most prominently reported outcomes. Few attempts were found to establish effects which could support claims that practitioner engagement can enhance the use of findings or impact health outcomes.

CONCLUSION

It is recommended that a culture of practitioner engagement is cultivated by developing guiding theory, establishing consistent terminology, and building an evidence base through empirical evaluations which provide objective data to support claims that this activity can positively influence the research practice gap.

Researcher practitioner engagement in health research: The development of a new concept

The engagement of frontline practitioners in the production of research-derived knowledge is often advocated. Doing so can address perceived gaps between what is known from research and what happens in clinical practice. Engagement practices span a continuum, from co-production approaches underpinned by principles of equality and power sharing to those which can minimalize practitioners' contributions to the knowledge production process. We observed a conceptual gap in published healthcare literature that labels or defines practitioners' meaningful contribution to the research process. We, therefore, aimed to develop the concept of "Researcher Practitioner Engagement" in the context of academically initiated healthcare research in the professions of nursing, midwifery, occupational therapy, physiotherapy, and speech and language therapy. Guided by Schwartz-Barcott et al.'s hybrid model of concept development, published examples were analyzed to establish the attributes, antecedents, and consequences of this type of engagement. Academic researchers (n = 17) and frontline practitioners (n = 8) with relevant experience took part in online focus groups to confirm, eliminate, or elaborate on these proposed concept components. Combined analysis of theoretical and focus group data showed that the essence of this form of engagement is that practitioners' clinical knowledge is valued from a study's formative stages. The practitioner's clinical perspectives inform problem-solving and decision-making in study activities and enhance the professional and practice relevance of a study. The conceptual model produced from the study findings forms a basis to guide engagement practices, future concept testing, and empirical evaluation of engagement practices.

Activities in Daily Living: The development of a new client-centred ADL intervention for persons with stroke

BACKGROUND

An intervention that contains several interacting components can be defined as a complex intervention. This intervention was developed in accordance with the Medical Research Council (MRC) guidance for complex interventions.

AIM

To describe the development, theoretical framework, and content of a client-centred activities in daily living intervention (CADL) for people with stroke.

MATERIAL AND METHODS

Different steps were used; identifying the evidence base, identifying/developing theory and the modelling process and outcomes in the development of the CADL. The remodelling of the process and content of the intervention that emerged are defined.

RESULTS

Findings from a series of qualitative studies of people with stroke demonstrated the need to develop an ADL intervention based on the clients' lived experiences. The theoretical framework is based on empirical research, theories about human occupation and client-centredness. The CADL is applying an occupational and phenomenological perspective in order to enable agency in daily activities and participation in everyday life among persons with stroke.

CONCLUSIONS AND SIGNIFICANCE

The article can be used as an example of how to present the development and theoretical framework of a new complex intervention in occupational therapy.

Home programmes based on evidence of best practice for children with unilateral cerebral palsy: Occupational therapists’ perceptions

Introduction

Evidence-based occupational therapy home programmes for children with unilateral cerebral palsy have demonstrated efficacy; however, uptake into routine practice is varied. The aim of this study was to gain a deeper understanding of the therapist-perceived supports and barriers to using occupational therapy home programmes for children with unilateral cerebral palsy, based on evidence of best practice in the United Kingdom.

Method

Fourteen occupational therapists completed semi-structured telephone interviews. Using a qualitative framework analysis approach, support and barrier factors were indexed against the Theoretical Domains Framework, before being categorised more broadly using the Capability, Opportunity, Motivation and Behaviour Model.

Findings

Common supports included: (a) strong leadership within the team to facilitate the translation of occupational therapy home programmes and evidence-based interventions into service-specific protocols; (b) knowledge exchange within professional networks and (c) mentorship. Common barriers included: (a) lack of resources; (b) restricted opportunities to review occupational therapy home programmes and (c) difficulties keeping up-to-date with the evidence in this area.

Conclusion

To be effective, occupational therapy home programmes need to be based on evidence of best practice; analysis indicated an urgent need to capture outcomes, record parental practice, further integrate ‘occupation’ within goal-setting, and develop use of conceptual models of practice to both enhance family-centred care and articulate the profession’s unique contribution.

Enablers and challenges to occupational therapists' research engagement: A qualitative study

INTRODUCTION

To develop occupational therapy's evidence base and improve its clinical outcomes, occupational therapists must increase their research involvement. Barriers to research consumption and leadership are well documented, but those relating to delivering research interventions, less so. Yet, interventions need to be researched within practice to demonstrate their clinical effectiveness. This study aims to improve understanding of challenges and enablers experienced by occupational therapists who deliver interventions within research programmes.

METHOD

Twenty-eight occupational therapists who participated in the Valuing Active Life in Dementia (VALID) research programme reported their experiences in five focus groups. Data were analysed thematically to identify key and subthemes.

RESULTS

Occupational therapists reported that overwhelming paperwork, use of videos, recruitment and introducing a new intervention challenged their research involvement, whereas support, protected time and a positive attitude enabled it. The impact of these challenges and enablers varied between therapists and organisations.

CONCLUSION

Challenges and enablers to research involvement can be identified but must be addressed within individual and organisational contexts. Multifaceted collective action to minimise challenges and maximise enablers can facilitate clinicians' involvement in research. Using this approach should enable occupational therapists to increase their research involvement, thus demonstrating the clinical effectiveness of their interventions.

Barriers and facilitators of participation in intervention research by mental health occupational therapists

Statement of context

Occupational therapists in clinical practice are required to deliver interventions within clinical trials to demonstrate the effectiveness of occupational therapy interventions. Challenges to participation in intervention research by occupational therapists working in community mental health have been identified and require further investigation.

Critical reflection on practice

A cross-sectional online survey of occupational therapists working in mental health was used, and obtained a 50% ( n = 144) response rate. Limited time, large generic caseloads, and lack of skills and experience in research were identified barriers to participation in occupational therapy intervention research. Occupational therapists had limited dedicated time to carry out occupational therapy interventions and outcome measurement was limited.

Implications for practice

Occupational therapy roles need to be regained in adult community mental health alongside routine outcome measurement. This will enable occupational therapy interventions to contribute to community mental health services and support participation in clinical trials of occupational therapy interventions.

Le partenariat en recherche

Description.

Les partenariats en ergothérapie entre les praticiens et les chercheurs sont importants pour produire des connaissances pertinentes pour la pratique clinique et pour favoriser la pratique fondée sur les données probantes au sein de la profession.

But.

Dans ce discours Muriel Driver, l’auteure discute des raisons pour lesquelles nous devons favoriser la participation des praticiens à la recherche et elle examine les conditions essentielles à la réussite des partenariats de recherche en collaboration.

Questions clés.

Les partenariats de collaboration peuvent réduire les obstacles empêchant les praticiens de participer à la recherche et permettre de veiller à ce que les initiatives de recherche soient plus pertinentes pour la pratique clinique. Les facteurs clés pour établir et maintenir des partenariats significatifs sont la présence de conditions préalables et favorables au partenariat en lien avec le contexte, de même que l’utilisation de principes directeurs axés sur la vision, les valeurs, la confiance, la communication, le partage du pouvoir et les interactions.

Conséquences.

Plusieurs des facteurs identifiés comme étant favorables à la réussite d’un partenariat de collaboration correspondent aux rôles fondamentaux des ergothérapeutes et témoignent de nos valeurs professionnelles. La prise en compte de ces facteurs lors de l’établissement de collaborations de recherche permettrait d’accroître les probabilités de réussite.

Partnership in research: A vehicle for reaching higher summits

BACKGROUND

Partnerships in occupational therapy between practitioners and researchers are important to advance knowledge relevant to clinical practice and support evidence-based practice in the profession.

PURPOSE

This Muriel Driver lecture discusses why we should support practitioners' engagement in research and examines essential conditions required for successful collaborative partnerships in research.

KEY ISSUES

Collaborative partnerships can alleviate the challenges preventing practitioners from participating in research and ensure that research initiatives are more relevant to clinical practice. Key factors for building and sustaining meaningful partnerships include the presence of favourable pre-partnership conditions related to the context and the use of guiding principles focusing on vision, values, trust, communication, power sharing, and interactions.

IMPLICATIONS

Several of the factors found to foster a good collaborative partnership are consistent with our core competency roles and reflect our professional values. Being mindful of these factors when initiating research collaborations would increase the likelihood of success.