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Use of the theoretical domains framework to develop an intervention to improve physical therapist management of the risk of falls after discharge

PHYS THER , 2014, vol. 94, n° 11, p. 1660-1675
Doc n°: 172024
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.2522/ptj.20130412

Older adults have an increased risk of falls after
discharge from the hospital. Guidelines to manage this risk of falls are well
documented but are not commonly implemented. The aim of this case report is to
describe the novel approach of using the Theoretical Domains Framework (TDF) to
develop an intervention to change the clinical behavior of physical therapists.
This project had 4 phases: identifying the evidence-practice
gap, identifying barriers and enablers that needed to be addressed, identifying
behavior change techniques to overcome the barriers, and determining outcome
measures for evaluating behavior change. OUTCOMES: The evidence-practice gap was
represented by the outcome that few patients who had undergone surgery for hip
fracture were recognized as having a risk of falls or had a documented referral
to a community agency for follow-up regarding the prevention of falls. Project
aims aligned with best practice guidelines were established; 12 of the 14 TDF
domains were considered to be relevant to behaviors in the project, and 6
behavior change strategies were implemented. Primary outcome measures included
the proportion of patients who had documentation of the risk of falls and were
referred for a comprehensive assessment of the risk of falls after discharge from
the hospital. DISCUSSION: A systematic approach involving the TDF was useful for
designing a multifaceted intervention to improve physical therapist management of
the risk of falls after discharge of patients from an acute care setting in South
Australia, Australia. This framework enabled the identification of targeted
intervention strategies that were likely to influence health care professional
behavior. Early case note audit results indicated that positive changes were
being made to reduce the evidence-practice gap.
CI - (c) 2014 American Physical Therapy Association.

Langue : ANGLAIS

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