Perspectives from clinicians and managers: facilitators and barriers to the uptake of rehabilitation guidance for children with arthrogryposis
Creators: name: McBain, Kimberly
name: Dinh, Cameron
name: Haffar, Melanie
name: Steinberg, Emily
name: Cachecho, Sarah
name: Bussières, André
name: Dahan-Oliel, Noémi
Publisher: name: Taylor & Francis
Year: 2023
Subjects: subject: Medicine
subject: Cell Biology
subject: Pharmacology
subject: Environmental Sciences not elsewhere classified
subject: Ecology
subject: FOS: Biological sciences
subject: Biological Sciences not elsewhere classified
subject: Science Policy
subject: Mental Health

description: To identify the perceived facilitators and barriers among clinicians and managers about the uptake of expert guidance for rehabilitation of children with arthrogryposis multiplex congenita (AMC) in practice. Qualitative study using individual interviews, guided by the Theoretical Domains Framework (TDF), to explore beliefs and to identify facilitators and barriers to guidance uptake. Interviews were conducted with a convenience sample of 15 clinicians working with children with AMC and four pediatric clinical managers using Microsoft Teams©. Interviews were then transcribed verbatim and analyzed by four independent reviewers using deductive and inductive coding. The TDF domains of Environmental Context and Resources, Behavioural Regulation, Reinforcement, Beliefs about Consequences, and Social Influences were shared amongst clinicians and clinical managers across North America and Europe as being relevant and influential on the target behaviour of using rehabilitation expert guidance to manage pediatric patients. Among clinicians only, the domain Memory, Attention, and Decision-Making Processes was also found relevant. Among managers only, the domain Social/Professional Role and Identity was found relevant. Coupling shared relevant domains amongst clinicians and managers with individual supports and barriers helps to map out what is needed to promote the uptake of rehabilitation guidance at multiple levels. The uptake of expert guidance is helpful for rehabilitation professionals to align best practice with expert opinion based on clinicians and lived experience for a condition as rare as arthrogryposis multiplex congenita (AMC).In order to facilitate the uptake of guidance, rehabilitation professionals and clinical managers need to collaborate during the development and uptake in practice.Rehabilitation professionals require support for the uptake of guidance, such as training, regular team encounters, and a knowledge broker.Rehabilitation professionals and clinical managers should be aware of identified facilitators and barriers to the uptake of guidance, such as time, clinical resources, and accessibility. The uptake of expert guidance is helpful for rehabilitation professionals to align best practice with expert opinion based on clinicians and lived experience for a condition as rare as arthrogryposis multiplex congenita (AMC). In order to facilitate the uptake of guidance, rehabilitation professionals and clinical managers need to collaborate during the development and uptake in practice. Rehabilitation professionals require support for the uptake of guidance, such as training, regular team encounters, and a knowledge broker. Rehabilitation professionals and clinical managers should be aware of identified facilitators and barriers to the uptake of guidance, such as time, clinical resources, and accessibility.