Promoting the use of self-management in novice chiropractors treating individuals with spine pain: the design of a theory-based knowledge translation intervention


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Eilayyan, Owis, Thomas, Aliki, Hallé, Marie-Christine, Ahmed, Sara, Tibbles, Anthony, Jacobs, Craig, Mior, Silvano, Davis, Connie, Evans, Roni, Schneider, Michael, Alzoubi, Fadi, Barnsley, Jan, Long, Cynthia et Bussières, André (2018). Promoting the use of self-management in novice chiropractors treating individuals with spine pain: the design of a theory-based knowledge translation intervention. BMC Musculoskeletal Disorders, 19 (1). ISSN 1471-2474 DOI 10.1186/s12891-018-2241-1

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Background Clinical practice guidelines generally recommend clinicians use self-management support (SMS) when managing patients with spine pain. However, even within the educational setting, the implementation of SMS remains suboptimal. The objectives of this study were to 1) estimate the organizational readiness for change toward using SMS at the Canadian Memorial Chiropractic College (CMCC), Toronto, Ontario from the perspective of directors and deans, 2) estimate the attitudes and self-reported behaviours towards using evidence-based practice (EBP), and beliefs about pain management among supervisory clinicians and chiropractic interns, 3) identify potential barriers and enablers to using SMS, and 4) design a theory-based tailored Knowledge Translation (KT) intervention to increase the use of SMS. Methods Mixed method design. We administered three self-administered questionnaires to assess clinicians’ and interns’ attitudes and behaviours toward EBP, beliefs about pain management, and practice style. In addition, we conducted 3 focus groups with clinicians and interns based on the Theoretical Domain Framework (TDF) to explore their beliefs about using SMS for patients with spine pain. Data were analysed using deductive thematic analysis by 2 independent assessors. A panel of 7 experts mapped behaviour change techniques to key barriers identified informing the design of a KT intervention. Results Participants showed high level of EBP knowledge, positive attitude of EBP, and moderate frequency of EBP use. A number of barrier factors were identified from clinicians (N = 6) and interns (N = 16) corresponding to 7 TDF domains: Knowledge
Environmental context and resources
Beliefs about Capabilities
Memory, attention & decision making
and Social Influence. To address these barriers, the expert panel proposed a multifaceted KT intervention composed of a webinar and online educational module on a SMS guided by the Brief Action Planning, clinical vignettes, training workshop, and opinion leader support. Conclusion SMS strategies can help maximizing the health care services for patients with spine pain. This may in turn optimize patients’ health. The proposed theory-based KT intervention may facilitate the implementation of SMS among clinicians and interns.

Type de document: Article
Mots-clés libres: United Kingdom–UK Behavior Diabetes Theory Spine Pain Management Chiropractic Medicine Clinical Medicine Instructional Design Intervention Chronic Illnesses Training Professions Patients Data Processing Translation Bibliometrics Knowledge Decision Making Empowerment Data Bases Attitudes Management Systematic Review Pain
Date de dépôt: 12 avr. 2019 19:07
Dernière modification: 12 avr. 2019 19:07
Version du document déposé: Version officielle de l'éditeur

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