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Implement Sci. 2015 Nov 5;10:157. doi: 10.1186/s13012-015-0346-6.

A multi-faceted knowledge translation approach to support persons with stroke and cognitive impairment: evaluation protocol.

Author information

1
Sunnybrook Research Institute, Toronto, Canada. sara.mcewen@utoronto.ca.
2
University of Toronto, Toronto, Canada. sara.mcewen@utoronto.ca.
3
Sunnybrook Health Sciences Centre, Toronto, Canada.
4
University of Toronto, Toronto, Canada.
5
Rotman Research Institute, Baycrest, Toronto, Canada.
6
University of Ottawa, Ottawa, Canada.
7
Bloorview Research Institute and Holland Bloorview Kids Rehab Hospital, Toronto, Canada.

Abstract

BACKGROUND:

Patients with cognitive impairments following a stroke are often denied access to inpatient rehabilitation. The few patients with cognitive impairment admitted to rehabilitation generally receive services based on outdated impairment-reduction models, rather than recommended function-based approaches. Both reduced access to rehabilitation and the knowledge-to-practice gap stem from a reported lack of skills and knowledge regarding cognitive rehabilitation on the part of inpatient rehabilitation team members. To address these issues, a multi-faceted knowledge translation (KT) initiative will be implemented and evaluated. It will be targeted specifically at the inter-professional application of the cognitive orientation to daily occupational performance (CO-OP). CO-OP training combined with KT support is called CO-OP KT. The long-term objective of CO-OP KT is to optimize functional outcomes for individuals with stroke and cognitive impairments. Three research questions are posed: 1. Is the implementation of CO-OP KT associated with a change in the proportion of patients with cognitive impairment following a stroke accepted to inpatient rehabilitation? 2. Is the implementation of CO-OP KT associated with a change in rehabilitation clinicians' practice, knowledge, and self-efficacy related to implementing the CO-OP approach, immediately following and 1 year later? 3. Is CO-OP KT associated with changes in activity, participation, and self-efficacy to perform daily activities in patients with cognitive impairment following stroke at discharge from inpatient rehabilitation and at 1-, 3-, and 6-month follow-ups?

METHODS/DESIGN:

Three interrelated studies will be conducted. Study 1 will be a quasi-experimental, interrupted time series design measuring monthly summaries of stroke unit level data. Study 2, which relates to changes in health care professional practice and self-efficacy, will be a single group pre-post evaluation design incorporating chart audits and a self-report survey. Study 3 will assess patient functional outcomes using a non-randomized design with historical controls. Assessments will occur during admission and discharge from rehabilitation and at 1, 3, and 6 months following discharge from rehabilitation.

DISCUSSION:

This project will advance knowledge about the degree to which the implementation of a supported KT initiative can sustainably change health system, knowledge, and patient outcomes.

PMID:
26542936
PMCID:
PMC4635536
DOI:
10.1186/s13012-015-0346-6
[Indexed for MEDLINE]
Free PMC Article

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