Evidence based practice and knowledge translation: A survey of Australian occupational therapy practice with clients experiencing neurocognitive impairments

Abstract

Introduction:The clinical practice patterns and use of research evidence by Australian occupational therapists working with clients experiencing neurocognitive impairments has not been surveyed for nearly 10 years. This survey aimed to evaluate the current status of occupational therapy practice and evidence use and provide recommendations for ongoing evidence translation. Methods: An online survey of occupational therapists working in Australia was conducted over four months targeting registered clinicians working with adults experiencing neurocognitive impairments. Results: 191 occupational therapists from a wide range of clinical practice areas, with a significant level of experience completed the survey. Functional retraining (n = 180, 94%), compensatory training (n = 173, 91%) and task/environmental modifications (n = 161, 84%) were the most commonly reported intervention techniques, while more targeted interventions such as context-sensitive training (n = 54, 28%), positive behaviour supports (n = 42, 22%) and metacognitive strategy training (n = 37, 19%) were used less frequently. Half the respondents were aware of current research evidence and suggested a wide range of strategies supporting evidence translation. Traditional barriers of limited time, access and skills to interpret research were also reported. Conclusion: Consistent with earlier surveys most occupational therapists continue to use a functional/compensatory approach to cognitive rehabilitation, with an increasing number of therapists using specialist cognitive interventions. The current challenge for occupational therapists is embedding specialist techniques into occupation-based intervention. Knowledge translation and implementation strategies will be a critical component to achieving this. K E Y W O R D S acquired brain injury , evidence based practice, knowledge translation , metacognitive strategy training, occupational therapy | 75 NOTT eT al.

Occupational therapy practice to support executive function impairment after acquired brain injury: A UK clinical survey

“…Use of functional training, task modification and compensatory training identified by participants to treat EFI are deemed traditional practice approaches used in cognitive rehabilitation, and consistent with clinical practice in previous surveys (Koh et al, 2009;Korner et al, 2011;Nott et al, 2020). In comparison, this study also identified use of goal setting which is less cited in literature exploring occupational therapy practice in cognitive rehabilitation, with the exception of recent multidisciplinary studies (Downing et al, 2019;Nowell et al, 2020).…”

“…The questionnaire was developed from a literature review of occupational therapy practice for the management of EFI completed by the principal author. The author also contacted an author of a clinical survey undertaken in Australia in 2020 (Nott et al, 2020) Operational definitions for key terms were identified and provided to participants.…”

Screening for Scientific Skills in Spanish-Speaking Occupational Therapists (HACTO-Screen): Study Protocol of a Cross-Sectional Survey

“…Nevertheless, understanding the process of EBP in occupational therapy also includes, in parallel, identifying barriers to its use. Intriguingly, despite the available literature suggesting that EBP is widely perceived as positive by occupational therapists, several studies identified the lack of confidence and skills in appraising research analysis as a common obstacle to applying research-based knowledge in occupational therapy practice [4,6,8,[16][17][18]. Moreover, some studies also indicated that limited time available, restrictions on access to research literature, fieldwork educators not practicing EBP, and/or putting higher value on clinical experience rather than research were seen as barriers particularly relevant to clinical settings or the workplace [4,6,7,[16][17][18][19][20].…”

Trouble neurocognitif majeur et méthodes optimisant l’apprentissage

“…La formation devrait également agir sur les croyances des proches aidants à ce sujet. L’enseignement sur les méthodes optimisant l’apprentissage et leur application à des situations rencontrées viendrait ainsi pallier le fait que les interventions utilisées auprès des personnes vivant avec un TNCM sont majoritairement compensatoires (Nott et al, 2020). Ces interventions telles que la livraison de repas ou l’aide au bain, bien qu’aidantes pour le maintien à domicile, permettent rarement l’utilisation des capacités préservées chez la personne vivant avec un TNCM.…”

“…Les travaux d’Amieva et ses collaborateurs (2012) soutiennent que les proches aidants souhaitent recevoir de l’information sur la maladie, son évolution, les traitements possibles ainsi que sur les habiletés nécessaires pour optimiser le soutien de la personne vivant avec un TNCM. Or, la plupart des services actuellement offerts à ces personnes et à leurs proches sont de nature compensatoire (Nott, Barden, Chapparo, & Ranka, 2020). Permettant peu l’utilisation des capacités préservées des personnes vivant avec un TNCM, les interventions compensatoires entraînent souvent des refus de services et l’apparition d’expressions comportementales des troubles neurocognitifs (symptômes comportementaux et psychologiques de la démence [SCPD]), dont certains sont connus comme des facteurs pouvant précipiter l’admission en ressource d’hébergement en institution (Okura et al, 2011).…”