To what extent are guidelines used in spasticity clinics? A qualitative study of facilitators and barriers to spasticity guideline implementation.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
Read More Add to Saved list
  • Additional Information
    • Source:
      Publisher: SAGE Publications Country of Publication: England NLM ID: 8802181 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1477-0873 (Electronic) Linking ISSN: 02692155 NLM ISO Abbreviation: Clin Rehabil Subsets: MEDLINE
    • Publication Information:
      Publication: London : SAGE Publications
      Original Publication: London : Edward Arnold ; New York : Cambridge University Press [distributor in North America], c1987-
    • Subject Terms:
      Muscle Spasticity*/rehabilitation ; Muscle Spasticity*/etiology ; Muscle Spasticity*/therapy ; Qualitative Research* ; Guideline Adherence* ; Practice Guidelines as Topic*; Humans ; Victoria ; Female ; Male ; Attitude of Health Personnel
    • Abstract:
      Objective: To determine the common understanding of focal muscle spasticity guidelines amongst clinicians working in spasticity clinics. To examine the facilitators and barriers to their implementation as well as their influence on clinic processes.
      Design: A qualitative study based on a phenomenological approach.
      Setting: Online videoconferencing platform.
      Participants: Sixteen experienced multi-disciplinary clinicians providing specialised care across 12 spasticity clinics in Victoria, Australia.
      Intervention: Observational.
      Main Measures: Two independent reviewers performed line by line coding of transcripts. Reflexive thematic analysis was undertaken with themes/subthemes inductively derived.
      Results: Seven key themes emerged. First, knowledge of specific guideline recommendations was low amongst some clinicians. Second, there is a lack of health service resources to support guideline implementation. Third, a limited evidence base for guidelines affected clinicians' willingness to implement the recommendations. Fourth, peer support was highly valued but opportunities to collaborate were limited. Fifth, a large amount of intrinsic motivation and personal time was required from clinicians to successfully implement guideline recommendations. Sixth, the standardisation of clinic processes was one way in which clinicians felt they could better align their clinical practice to guidelines. Lastly, guidelines overall had a moderate influence on spasticity clinic processes.
      Conclusions: Knowledge of recommendations varied but, overall, guidelines had an influence on clinic processes and staff perceptions across the state-wide services. Health service resources, limited evidence for guideline recommendations and time constraints were considered barriers to spasticity guideline implementation. Multi-disciplinary expertise and teamwork, the individual's motivation to change and inter-clinic collaboration were considered to be the facilitators.
      Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
    • Contributed Indexing:
      Keywords: clinical guideline implementation; focal muscle spasticity; knowledge translation
    • Publication Date:
      Date Created: 20240320 Date Completed: 20240826 Latest Revision: 20240827
    • Publication Date:
      20240828
    • Accession Number:
      10.1177/02692155241239811
    • Accession Number:
      38505935