Rehabilitation Health Professionals Research Articles

Validation of the Work-Related Quality of Life Scale in Rehabilitation Health Workers: A Cross-Sectional Study.

Work-related quality of life (WRQoL) is a multidimensional concept related to life satisfaction. Evaluating WRQoL is essential in healthcare settings since employee satisfaction affects patient service quality. Only a few studies have focused on the quality of life of rehabilitation health workers. We aimed to validate the Italian version of the WRQoL scale on a population of rehabilitation health professionals; the secondary objective was to investigate the work-related quality of life of professionals concerning the work settings in which they operate. Participants were recruited from January 2022 to December 2023 according to specific inclusion criteria. Questionnaires were administered through an online survey requiring also personal employment data, and together with the SF-12 questionnaire, a test-retest was performed on 30 therapists. Reliability was assessed with Cronbach's alpha, test-retest stability through intraclass correlation coefficient (ICC), and concurrent validity was calculated using Pearson's correlation. We enrolled 284 individuals. Internal consistency analysis showed statistically significant results: Cronbach's alpha was > 0.70; construct validity analyses revealed statistically significant data for total scores and subscales, compared to SF-12 scores. The WRQoL scale is a valid and reliable tool to assess the quality of working life of rehabilitation professionals.

Psychometric validation of the Patient-Reported Outcomes Measurement Information System Global Health Scale for people with multiple sclerosis.

The coronavirus disease 2019 pandemic and postpandemic era have significantly impacted the physical, mental, and social health (global health) of people with multiple sclerosis (MS). Extensive evidence highlights the positive relationships among global health, employment, and subjective well-being. For rehabilitation psychologists and health professionals serving individuals with MS, it is crucial to incorporate a global health measure into their assessment toolkit. The Patient-Reported Outcomes Measurement Information System Global Health (PROMIS©GH) Scale is widely used and validated for diverse patient populations worldwide. However, there is no study that validates the PROMIS©GH for people with MS. We conducted an exploratory factor analysis with a sample of U.S. adults with MS (N = 495) to examine the measurement structure of the PROMIS©GH. Exploratory factor analysis results indicated a two-factor measurement structure (physical health and mental-social health) that accounted for 67.80% of the total variance. All items loaded highly onto their respective factors (ranging from 0.59 to 0.93). The Cronbach's α of the two subscales was .85 and .86, which is high for very brief measures. The two factors were significantly and positively associated with employment, subjective well-being, resilience, core self-evaluations, and social support, and negatively associated with stress and depression in the theoretically expected directions, supporting its construct validity. The findings of this study indicated that PROMIS©GH is a psychometrically sound global health measure for people with MS and should be included as a health assessment tool for rehabilitation psychologists and health professionals who provide services to people with MS. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Vocational rehabilitation for Long Covid: a roadmap for recovery

Long Covid continues to impact many people’s workability; some have lived with it for years, experiencing return-to-work attempts followed by redeployment, contractual changes—even capability proceedings. For those in low-paid work or self-employment, contractual or financial insecurity, work retention options are likely to be reduced even further. New cases of Long Covid continue, and the need to support workers earlier in their trajectory with return to work as a key outcome remains crucial. Support for people with Long Covid has been lacking to date; here we introduce a practical tool that can be utilized by rehabilitation and occupational health professionals alike.

Prevalence of burnout syndrome in rehabilitation health professionals during COVID-19 pandemic: a cross-sectional study

Background Burnout syndrome is the result of prolonged occupational stress. Working under high-stress conditions further exacerbated by COVID-19 may impose an additional psychological burden on rehabilitation health professionals (RHPs) and affect their psycho-social health. Objectives This study was conducted to determine the burnout levels of RHPs working during the COVID-19 pandemic and to examine its relationship with various clinical and demographic data. Methods In this cross-sectional study, participants were asked to fill out an anonymous questionnaire containing demographic information and the Maslach Burnout Inventory (MBI). Three sub-dimensions of burnout; emotional exhaustion (EE), depersonalization (DP) and personal achievement (PA) were evaluated. Results A total of 84 participants, most of whom were physiotherapists (56%), attended in the study. The rate of participants experiencing burnout was found to be 25%. The mean score was 20 ± 13.1, 6.7 ± 5.4, and 27.8 ± 10.1 for the EE, DP, and PA subgroups, respectively. Proportionally, 28.6% of participants had high burnout levels for the EE subgroup, 27.4% for the DP subgroup, and 60.7% for the PA subgroup. The mean DP scores were statistically significantly higher in females (p < 0.05). Conclusions This study is one of the few studies examining the frequency and components of burnout syndrome in RHPs in the COVID-19 pandemic. Burnout was observed in RHPs at levels of up to 25% in the general evaluation and up to 60.7% in the subgroup analysis. Occupational burnout is a health problem that needs attention for RHPs and should be evaluated more carefully in the presence of additional stressors such as COVID-19.

Deafness and Communicative Barriers with reference to University Courses in the Rehabilitation area

Abstract Introduction Deafness frustrates communication. It creates a communication deficit/barrier between the deaf person and the hearing community. Without appropriate training of Healthcare staff in effective communication strategies, this gap can marginalize/exclude the Deaf Community by denying them access to necessary Healthcare provision with adverse outcome for diagnostic and therapeutic success. This study highlights the pressing need for and desire of Healthcare staff for training in effective communication strategies, the willingness of University Healthcare Degree Course Directors to explore this, and the perspective of the Deaf community itself, entitled to equal access to Healthcare Material and Methods Using the Google forms platform, online questionnaires were given to the 3 stakeholders all over Italy: Deaf people DP; Rehabilitation Healthcare Staff RHS; University Degree Course Directors in Rehabilitation UDCDR. Data Analysis was carried out using the Google Forms program, SPSS program Windows7 Excel Spreadsheet. Results 252 RHS (89% women) participated, (92.9%) interested in Courses about Communication with Deaf People (57% of these had deaf patients, but only 45% had specific training). 39 DCHR took part (39,4% Heads of Speech Therapy courses and 35,3% Heads of Developmental Neuro-Psychomotricity Therapy courses). These Heads do not foresee training courses on the subject, even though 92% of them consider it quite/ very important for their students’ formation. 23 DP participated (69% aged 18-45); 56% report having received simplistic communications solely because they are deaf; 78% had problems in establishing a relationship of trust with health staff, due to communication barriers. Conclusions Both health workers and deaf people identify significant training needs to overcome communication barriers. Apropos, the UDCDR involved show their willingness to pursue further study of this. Key messages • This study highlights the need to train health workers in essential communication strategies with deaf people, to reduce the significant barriers that prevent their access to appropriate therapy. • There is a need for training in effective communication strategies between deaf people and Rehabilitation Health Professionals. Training should be duly adapted to provide all inclusive Healthcare.

If you measure it, it matters!: a survey of factors influencing implementation of physical activity promotion in cardiac and pulmonary rehabilitation in Australia

ObjectiveTo identify factors related to the frequency of physical activity (PA) promotion by health professionals working in cardiac and/or pulmonary rehabilitation. MethodsA cross-sectional online survey of health professionals working in cardiac and/or pulmonary rehabilitation in Australia was conducted between July and November 2022. ResultsA total of 71 health professionals from four disciplines (physiotherapy, nursing, exercise physiology, occupational therapy) completed the survey. The majority agreed that PA promotion was part of their role. Despite this, only half of the participants encouraged ≥ 10 patients per month to be more physically active. In logistic regression modelling, health professionals that measured patients’ PA levels (odds ratio 8.04, 95% confidence level 1.45–44.19) and prioritised PA promotion regardless of other patient problems (odds ratio 3.3, 95% confidence level 0.74–14.82) were much more likely to frequently promote PA to patients. ConclusionMeasurement of patients’ PA levels within cardiac and pulmonary rehabilitation and making PA promotion a priority may impact the implementation of PA promotion within these programs. Practical ImplicationsPhysical activity measurement as a key performance indicator in cardiac and pulmonary rehabilitation is indicated. This may be an important strategy to increase physical activity promotion by cardiac and pulmonary rehabilitation health professionals.

Analysis of burnout and fulfillment levels in rehabilitation health professionals

Analysis of burnout and fulfillment levels in rehabilitation health professionals

"Working Together": Perspectives of Healthcare Professionals in Providing Virtual Care to Youth with Chronic Pain during the COVID-19 Pandemic.

The onset of the coronavirus disease in 2019 necessitated a rapid transition to virtual care for chronic pain treatment. A mixed methods design was implemented using qualitative interviews and quantitative satisfaction surveys. Interviews were conducted in February 2021 with a sample of healthcare professionals (HCPs; n = 6) who had provided multidisciplinary treatment (MDT) through an outpatient hospital pediatric chronic pain program. Satisfaction surveys were distributed to all MDT professionals employed by the clinic in April 2021 (n = 13 of 20 eligible; 65% response rate). Participants represented medicine, rehabilitation, and mental health professionals. Analysis of interviews generated five themes: (1) adaptation to virtual care, (2) benefits of virtual care, (3) limitations of virtual care, (4) shifting stance on virtual care over time, and (5) considerations for implementing virtual care. The satisfaction survey data revealed that respondents were able to effectively provide appropriate diagnoses, recommendations, and/or care plans for pediatric chronic pain via virtual care (n = 12, 92.3%). Detailed survey responses are presented by discipline. This study provides a rich exploration of HCPs' experiences in providing MDT for pediatric chronic pain within a virtual care model. The current results may contribute to the future development of guidelines for virtual care delivery with pediatric chronic pain populations.

Implementing the Patient Needs in Asthma Treatment (NEAT) questionnaire in routine care: a qualitative study among patients and health professionals

BackgroundMany patients with asthma report unmet health care needs. The Patient Needs in Asthma Treatment (NEAT) questionnaire is a validated instrument to quantify these unmet needs. We explored how health professionals evaluated the instrument’s utility as well as patients’ and professionals’ perspectives of how NEAT could be incorporated into routine clinical practice.MethodsQualitative interviews were conducted by telephone between February and September 2021 with 19 patients with asthma and 21 health professionals (i.e., general practitioners, pneumologists, health professionals in pulmonary rehabilitation, and medical assistants). Interview recordings were transcribed verbatim and content-analyzed using both deductive and inductive approaches using MAXQDA.ResultsHealth professionals could see the potential value of using NEAT to inform clinical decisions. However, health professionals tended to be skeptical towards the routine use of NEAT in outpatient settings, mainly due to a lack of time. Implementation of NEAT was seen as more valuable in the context of patient education (i.e., in Disease Management Programs [DMPs] or pulmonary rehabilitation) by patients and health professionals alike, because it offered greater opportunities to address any unmet needs identified. Both patients and health professionals considered it more useful to use the questionnaire for the first time some time after the initial diagnosis has been made (e.g., when the treatment regime is found rather than at time of initial diagnosis). In the context of DMPs and pulmonary rehabilitation, NEAT could be used twice, i.e., before and after patient education to support patient-centered planning and evaluation.ConclusionBoth patients and health professionals consider the use of the NEAT, in particular in educational programs (i.e., during DMPs or pulmonary rehabilitation), as feasible and useful. There is now a need to undertake a feasibility trial in routine care.

Cochrane "evidence relevant to" rehabilitation of people with post COVID-19 condition. What it is and how it has been mapped to inform the development of the World Health Organization recommendations.

Cochrane Rehabilitation developed a series of actions to provide the global rehabilitation community with the best available evidence to respond to the COVID-19 pandemic. These initiatives constituted the REH-COVER (Rehabilitation COVID-19 evidence-based response) action. In March 2020, the first initiative started in agreement with the European Journal of Physical and Rehabilitation Medicine (EJPRM): the rapid systematic review of all papers relevant to COVID-19 rehabilitation to inform rehabilitation health professionals rapidly. Currently, we are facing the long-term consequences of COVID-19, initially called "long Covid" and now named post COVID-19 condition (PCC), which led to the request by the WHO Rehabilitation Programme for evidence synthesis to support the development of specific recommendations. Cochrane Rehabilitation provided the best available evidence from the REH-COVER rapid living systematic review results, a systematic scoping review on the models of care and a summary of "evidence relevant to" the rehabilitation for adults with PCC. Based on this evidence, expert groups developed the 16 recommendations for the rehabilitation of adults with PCC recently published in Chapter 24 of the WHO "Clinical management of COVID-19 living guideline." This paper aims to introduce the Special Section of EJPRM reporting the work performed by Cochrane Rehabilitation to produce a summary of the existing "evidence relevant to" the rehabilitation of adults with PCC. The paper reports the methodology (overview of systematic reviews with mapping) and introduces the concept of "evidence relevant to" rehabilitation.

A scoping review of virtual synchronous intervention studies in preschool rehabilitation

Purpose To summarize the available evidence for the delivery of synchronous virtual rehabilitation intervention services for preschoolers and to identify key factors associated with virtual intervention. Methods Five databases were searched to identify peer-reviewed articles that assessed virtual interventions for preschoolers delivered by rehabilitation health professionals including physical therapists, occupational therapists, speech-language pathologists, audiologists, and their associated assistants. Relevant data regarding demographics, technology, mode of service delivery, timing, engagement, and measurement data were extracted, and charted. Data were then summarized quantitatively using frequency counts, and qualitatively using descriptive summaries. Results Sixteen studies were identified. Virtual interventions primarily targeted language difficulties or disorders, therefore most services were delivered by a speech-language pathologist or audiologist. Most interventions were delivered using Skype or Zoom on a weekly basis. Various technological features (e.g., phonology software, ‘e-helpers’) were included, and multiple activities (e.g., playdough, bubbles) and strategies were used to support engagement. Conclusion This scoping review provides current knowledge about the delivery of virtual rehabilitation interventions for preschoolers to help guide best practices for clinicians. Future research could assess the validity of existing outcome measures in the virtual environment, and outline optimal session length and frequency for virtual preschool interventions.

P047 Rehabilitation-led management of sleep disordered breathing: adapting a model of care for a rehabilitation centre in Australia

Abstract Introduction Sleep disordered breathing (SDB) is highly prevalent in tetraplegia, yet most remain undiagnosed and untreated for the disorder. We have described the care models of three international SCI rehabilitation centres that are independently diagnosing and treating SDB, and distilled their common pathways into the SCISTAR (SCI Sleep disordered breathing Treatment &amp; Assessment in Rehabilitation) model. The aim of this project was to adapt the SCISTAR model to suit the Royal Rehab Spinal Injuries Unit, and to prepare for the implementation of this new model of care. Methods A clinical advisory group, consisting of researchers, rehabilitation and respiratory health professionals, met six times over eight months to: • identify the multidisciplinary SDB clinical team, • adapt the SCISTAR model, • develop parameters for safe clinical practice, • identify education needs, • identify and acquire the necessary equipment. Results The SDB clinical team consists of two rehabilitation consultants, two physiotherapists and four nurses. All patients with SCI will be assessed for SDB following admission. Assessments will include symptoms, spirometry and sniff nasal inspiratory pressure, and a Level 3 overnight sleep study (ResMed ApneaLink). Patients diagnosed with un-complicated SDB will be prescribed CPAP, which will be initiated and progressed on the ward. Screening for hypoventilation and predominant central sleep apnoea will occur throughout the pathway and if identified, patients will be referred to a specialist respiratory service. Comprehensive education and equipment has been provided. Conclusions The new care model is currently being piloted for 12 months. A comprehensive evaluation has been developed.

Development of a functional assessment task in metastatic breast cancer patients: the 30-second lie-to-sit test

Purpose To develop a physical function test based on lie-to-sit transition and to study its feasibility in patients suffering from metastatic breast cancer (MBC). Materials and methods This cross-sectional study recruited 90 women diagnosed with MBC. Patients were asked to transfer from lying to sitting position as fast as possible during 30 s, performing the 30-second lie-to-sit test (30-LTS). Heart rate (HR), rate of perceived exertion (RPE) and number of repetitions were measured. An assessment included the 30-second sit-to-stand test (30-STS), handgrip strength, Upper Limb Functional Index (ULFI) and Lower Limb Functional Index (LLFI). Pearson correlation was calculated between 30-LTS and independent outcomes. A linear regression model explaining the 30-LTS results was further constructed with variables that had a significant correlation. Results About 72 patients were measured, of which 65 were able to perform 30-LTS. Subjects performed 8.13 repetitions on average, with a mean RPE of 4.78 (0–10), reaching 63.08% of maximal HR. 30-LTS was significantly correlated with 30-STS (r = 0.567), handgrip (p = 0.26) and LLFI (r = 0.348). The regression model was significant (F = 4.742; p = 0.00), and these variables explained 32% of the variance of the 30-LTS. Conclusion The 30-LTS showed to be a feasible functional and submaximal test in a sample of MBC. IMPLICATIONS FOR REHABILITATION The 30-second lie-to-sit (30-LTS) developed does not require the patient to acquire a standing position and therefore it is an alternative to other more biomechanically demanding tests such as a 30 second sit-to-stand test or Timed up-and-go. 30-LTS involves both a functional and energy system assessment tool that can be implemented by allied health professionals in oncology rehabilitation to individualize exercise prescription, as well as for functional screening purposes. The present study adds value to current research focused on individualizing exercise prescription in the oncology field and provides reference values of function in metastatic breast cancer patients.

Examining the Role of Resilience and Hope in Grit in Multiple Sclerosis.

The purpose of this study was to examine the effects of resilience and hope on grit when controlling for demographic covariates, depression, and anxiety in people with multiple sclerosis (MS). This was a cross-sectional study with a sample of 348 participants with MS. Descriptive statistics were performed to examine participants' demographic characteristics. A three-step hierarchical regression analysis was conducted to evaluate the extent to which resilience and hope explain the unique variance in grit while controlling for demographic covariates, depression, and anxiety. Findings suggested that resilience and hope explained a significant amount of variance in grit when controlling for demographic covariates, depression, and anxiety. Furthermore, higher resilience and hope scores were associated with higher grit scores. Given that resilience, hope, and grit are modifiable, rehabilitation and mental health professionals (e.g., psychologists, psychiatrists, rehabilitation counselors) can integrate strength-based interventions into their practices to bolster resilience, hope, and grit in people with MS. Our paper also has implications for interdisciplinary research and clinical practice.

Collaborative co-design and evaluation of an immersive virtual reality application prototype for communication rehabilitation (DISCOVR prototype)

Purpose Virtual reality (VR) lends itself to communication rehabilitation by creating safe, replicable, and authentic simulated environments in which users learn and practice communication skills. The aim of this research was to obtain the views of health professionals and technology specialists on the design characteristics and usability of a prototype VR application for communication rehabilitation. Materials and Methods Nine professionals from different health and technology disciplines participated in an online focus group or individual online interview to evaluate the application and use of the VR prototype. Data sources were analysed using a content thematic analysis. Results Four main themes relating to VR design and implementation in rehabilitation were identified: (i) designing rehabilitation-focused virtual worlds; (ii) understanding and using VR hardware; (iii) making room for VR in rehabilitation and training; and (iv) implementing VR will not replace the health professional’s role. Discussion Health professionals and technology specialists engaged in co-design while evaluating the VR prototype. They identified software features requiring careful consideration to ensure improved usability, client safety, and success in communication rehabilitation outcomes. Continuing inclusive co-design, engaging health professionals, clients with communication disability, and their families will be essential to creating useable VR applications and integrating these successfully into rehabilitation. Implications for rehabilitation Health and technology professionals, along with clients, are integral to the co-design of new VR technology applications. Design of VR applications needs to consider the client’s communication, physical, cognitive, sensory, psychosocial, and emotional needs for greater usability of these programs. Realism and authenticity of interactions, characters, and environments are considered important factors to allow users to be fully immersed in virtual simulations to enhance rehabilitation.

A pulmonary rehabilitation shared decision-making intervention for patients living with COPD: PReSent: protocol for a feasibility study.

BackgroundDespite the variety of pulmonary rehabilitation programmes for patients living with COPD, uptake remains low. To improve this, it is recommended that health professionals engage patients in informed decisions about pulmonary rehabilitation. Shared decision-making (SDM) facilitates informed and value-based decision-making between patients and health professionals. This protocol describes the development and evaluation of a complex SDM intervention for patients living with COPD, who are referred for pulmonary rehabilitation, and their pulmonary rehabilitation health professional.Methods and analysisWe are developing a complex SDM intervention involving a patient decision aid (PtDA) and a decision coaching workshop. Prior to patient recruitment, pulmonary rehabilitation health professionals will attend the workshop. Upon referral to pulmonary rehabilitation, patients will receive the PtDA to support their decision-making prior to and during their pulmonary rehabilitation assessment with a health professional. The intervention will be evaluated in a one-arm exploratory study to investigate its feasibility and acceptability for patients and health professionals, with an integrated fidelity assessment. The primary outcome is recruitment feasibility, data collection feasibility and intervention fidelity. Secondary outcomes include routine pulmonary rehabilitation data, decisional conflict, patient activation, intervention attendance/attrition and patient and pulmonary rehabilitation health professional experience of the intervention. Quantitative outcomes will be evaluated using the most appropriate statistical test, dependent on the sample distribution. Qualitative outcomes will be evaluated using reflexive thematic analysis. Fidelity will be assessed using the Observer OPTION 5 scale.ConclusionThis intervention will provide structure for an informed and values-based decision-making consultation between a patient with COPD and a pulmonary rehabilitation health professional with the potential for optimising pulmonary rehabilitation decision-making.

Older patients’ perspectives on participating in multimodal rehabilitation including anabolic steroids following hip fracture: a qualitative study embedded within a pilot RCT

Purpose To explore patient perspectives of participating in a pilot RCT evaluating feasibility and effect of anabolic steroid, physiotherapy and nutritional supplement following hip fracture. Methods Semi-structured telephone-based interviews of 16 women and three men (average age 73 years) were conducted at baseline and after a 12-week intervention. Qualitative content analysis was performed. Results Two main categories were identified: (1) Trust and hope for a positive change with three sub-categories; reflections on anabolic steroids, anticipation of extra attention, lack of energy. (2) Curiosity, care, and commitment with four sub-categories; a sense of anabolic steroids, feeling of exclusivity and privileges, challenges and sense of obligation, and perspectives on personal gain. Conclusions Findings suggest high acceptability of the intervention. Participants motivated their participation on a trust that the intervention would “do more good than harm”. They found the randomization and possibility of receiving anabolic steroids intriguing, and especially valued trial participation because of their experience of getting extra care and “deluxe” rehabilitation including close contact and support by health professionals. Our findings may help inform future research recruiting older patients and generally considered relevant for health professionals in rehabilitation, emphasizing the impact of professional guidance and social support to encourage self-efficacy. Implications for rehabilitation With muscle enhancing medicine being suggested as a supplement in rehabilitation following hip fracture, exploring patients’ perspectives is warranted and may help inform future trials in this area. Factors reported as important by older adults for engaging in rehabilitation trials are: simple but thorough information, friendly and trustful relation with study staff and opportunities of extra care and attention. Older patients with hip fracture highly valued professional guidance and support by health professionals during the rehabilitation intervention. High acceptability was identified for the supervised outpatient rehabilitation, where especially the individually structured progressive strength training was highlighted as the “active ingredient” accelerating recovery and potentially promoted self-efficacy.

People with spinal cord injury in Morocco: results from the very first systematic data collection

Purpose To report on the methodology, participant characteristics, and associations of four most frequent environmental barriers with health conditions, general health and quality of life (QoL) in the very first systematic data collection in people with spinal cord injury (SCI) in Morocco. Materials and methods We obtained data from 385 participants of the cross-sectional Moroccan SCI community survey (MorSCI). We used descriptive statistics to describe participant characteristics and regression models to investigate associations of the five most frequently reported environmental barriers with health conditions (secondary conditions, pain intensity, mental health), general health and QoL. Results The most frequently reported environmental barriers were “lack of public services” (92.5%), “financial strain” (93.0%), restricted access to “public transportation” (85.5%), “public places” (83.9%) and “private places” (84.7%). People who perceived those factors as barriers also reported more secondary conditions, higher pain intensity, lower mental health, lower general health, and lower QoL. Conclusions This study on Moroccans with SCI found that environmental barriers detract from health and QoL. Given that environmental barriers are potentially modifiable, policy interventions present powerful tools to reduce barriers and potentially increase health and QoL in this vulnerable population. IMPLICATIONS FOR REHABILITATION Public policy on the construction of transportation and public places is important to make the physical environment accessible for wheelchair users to support their participation in society. The provision of adequate rehabilitation services and specialized post-acute rehabilitation units for people with SCI in Morocco is urgently needed, not only to contribute to health and QoL but also to contribute to their abilities to overcome environmental barriers. Adequate state services including universal health coverage and access to rehabilitation services and assistive devices or adapted tools must be a priority on the policy level to facilitate activities of daily living and reduce barriers. Improving the skills and knowledge of health professionals in SCI rehabilitation and guide policy makers to promote patient education and self-advocacy in the meantime, may help reduce the gap between needs of people with SCI and available support.

Acceptability of Health Professionals' Address of Sexuality and Erectile Dysfunction - A Qualitative Interview Study with Men in Cardiac Rehabilitation.

IntroductionIn the developing phase of the complex health intervention: Physical Activity to reduce Vascular Erectile Dysfunction (PAVED), it is crucial to explore whether men can accept the communicative component regarding information that regular aerobe Physical Activity can reduce Erectile Dysfunction (i-PAVED). This information is provided by health professionals (HPs) in cardiac rehabilitation, where sexuality issues such as erectile dysfunction (ED) are otherwise rarely addressed.AimTo explore how acceptance of cardiac HPs’ address of sexuality, ED, and i-PAVED can be identified in men's narratives.MethodsIn this descriptive qualitative study, we conducted semi-structured individual interviews with 20 men (range 48-78 years of age) attending municipal cardiac secondary prevention and rehabilitation programmes on their acceptance of HPs’ address of sexuality, ED, and i-PAVED. The Theoretical Framework of Acceptability components (affective attitude, burden, ethicality, intervention coherence, perceived effectiveness, opportunity costs and self-efficacy) and three temporal perspectives (retrospective, concurrent and prospective) were used in the concept-driven first step of a content analysis, which was followed by a thematically data-driven second step.Main Outcome MeasuresMen anticipated and experiential acceptance was identified in six out of seven components of Theoretical Framework of Acceptability.ResultsMen acceptance was identified as “expression of interest,” “addressing sexuality,” “attitudes and values,” “understandable and meaningful,” “insights” and “motivation,” whereas no narratives were identified in relation to the component of opportunity costs.ConclusionAs an aspect of the development of the complex cardiovascular health care intervention PAVED, this qualitative study showed that men attending cardiac secondary prevention and rehabilitation seemed to prospectively accept the communicative component of PAVED being HPs’ address of sexuality, ED, and i-PAVED, if the HPs are professional, educated and competent in the field of sexual health. Gerbild H, Areskoug-Josefsson K, Larsen CM, et al. Acceptability of Health Professionals’ Address of Sexuality and Erectile Dysfunction - A Qualitative Interview Study with Men in Cardiac Rehabilitation. Sex Med 2021;9:100369.

Why allied health professionals use evidence-based clinical guidelines in stroke rehabilitation: A systematic review and meta-synthesis of qualitative studies

Objective: To capture qualitative research about the perspectives and reasoning of allied health professionals about variability in the use of clinical guidelines in stroke rehabilitation. Data sources: Ovid Medline, Psychinfo, Cochrane, Ovid Emcare, Scopus and Web of Science. Method: The review protocol followed the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement. Qualitative or mixed methods research that provided qualitative data about use of clinical guidelines delivered by allied health professionals in stroke rehabilitation was included. Clinical guidelines included any evidence-based documents that guided allied health stroke rehabilitation practice. All studies were screened in duplicate at title and abstract and then at full text. Included studies were appraised using the McMaster Critical Appraisal Tool. Results: Data from 850 allied health professionals in 22 qualitative research studies from seven different countries were analysed and synthesised. Four themes were developed including: context necessitates strategy, all clients are different, systemic changes are needed and need a good reason to change something. The findings aligned with the four arms of evidence-base practice. Allied health professionals use clinical guidelines when they align with their reasoning and match the ‘sweet spot’ for client goals and circumstance. Clinical guideline use is attributed to sufficient resourcing, time and motivation and a strong research culture within health systems. Conclusions: Variabilities in clinical guideline use by allied health professionals are due to their clinical reasoning, contextual factors, client characteristics and enabling health systems.