Observed Interprofessional Collaboration (OIPC) During Interdisciplinary Team Meetings: Development and Validation of a Tool in a Rehabilitation Setting

Background: Despite all the efforts made in the past few years, interprofessional collaboration (IPC) in clinical settings is not always optimal. In addition, there are only a few instruments that healthcare managers and practitioners can use to evaluate the quality of IPC practice. Therefore, we developed an observationbased tool to evaluate IPC interactional factors occurring during interdisciplinary team meetings, and we examined the initial validation of the tool in a rehabilitation setting.Methods and Findings: The items were developed and pre-tested iteratively by construct experts (N = 7) and non-experts (N = 4). Interrater reliability was determined between two observers, following the analysis of 30 video recordings of meetings in two rehabilitation centres involving a total of 152 participants. An observation grid (OIPC) consisting of 20 items that can be answered on a threepoint scale and demonstrating acceptable interrater reliability was developed.Conclusions: The OIPC is a tool aimed at evaluating IPC interactional factors during interdisciplinary meetings based on team performance rather than individual behaviours. It can be useful for healthcare managers and practitioners who want to evaluate the quality of IPC practices

Consensus group sessions: a useful method to reconcile stakeholders’ perspectives about network performance evaluation

Background: Having a common vision among network stakeholders is an important ingredient to developing a performance evaluation process. Consensus methods may be a viable means to reconcile the perceptions of different stakeholders about the dimensions to include in a performance evaluation framework. Objectives: To determine whether individual organizations within traumatic brain injury (TBI) networks differ in perceptions about the importance of performance dimensions for the evaluation of TBI networks and to explore the extent to which group consensus sessions could reconcile these perceptions. Methods: We used TRIAGE, a consensus technique that combines an individual and a group data collection phase to explore the perceptions of network stakeholders and to reach a consensus within structured group discussions. Results: One hundred and thirty-nine professionals from 43 organizations within eight TBI networks participated in the individual data collection; 62 professionals from these same organisations contributed to the group data collection. The extent of consensus based on questionnaire results (e.g. individual data collection) was low, however, 100% agreement was obtained for each network during the consensus group sessions. The median importance scores and mean ranks attributed to the dimensions by individuals compared to groups did not differ greatly. Group discussions were found useful in understanding the reasons motivating the scoring, for resolving differences among participants, and for harmonizing their values

The effectiveness of dance therapy as an adjunct to rehabilitation of adults with a physical disability

Background/Objective: To determine the added benefit on participants’ mobility and participation of a 12-week dance therapy (DT) intervention combined with usual physical rehabilitation for adults with varied physical disabilities. Their appreciation of DT was also explored. Methods: We conducted a quasi-experimental study pre–post test with a nonequivalent control group and repeated measurements pre, post, and at a 3-month follow-up. Results: Although participants in both groups significantly improved over time (at 12 weeks and at follow-up) compared to baseline on mobility (timed up and go, TUG) and participation (e.g., Life-H scores and number of leisure activities), treatment effect analysis using propensity score matching showed no significant treatment effect of DT. The TUG scores showed the best promise of a treatment effect. DT participants’ Flow State Scale scores significantly improved (p < 0.01) for 5/9 dimensions of flow (being in control, loss of self-consciousness), and they all recommended DT. Conclusion: This study failed to demonstrate an added benefit of the DT intervention in improving participants’ mobility and participation. Overwhelmingly, favorable participants’ opinions about the intervention support its potential impact

Participatory co-creation of an adapted physical activity program for adults with moderate-to-severe traumatic brain injury

BackgroundResearch about using physical activity (PA) to improve health, quality of life, and participation after moderate-to-severe traumatic brain injury (TBI) is receiving growing attention. However, best-practices for maintaining PA participation after TBI have yet to be defined. In this context, a team of researchers and stakeholders with a moderate-to-severe TBI (including program participants and peer mentors) participated in a co-creation process to optimize a 9-month, 3-phased, community-based, adapted PA program named TBI-Health.PurposeThe study aimed to provide a detailed account of the participation in and co-creation of a new TBI-Health Program to enhance sport and exercise participation for adults with moderate-to-severe TBI. Specifically, we carried out an in-depth exploration of the perceived experiences and outcomes of users over one cycle of the program to assist the co-creation process.MethodsAn interpretive case study approach was used to explore the experiences and outcomes of the participatory co-creation within and across phases of the TBI-Health program. A purposeful sample of fourteen adults with moderate-to-severe TBI (program participants n = 10; peer mentors n = 4) were involved in audio-recorded focus groups after each program phase. Reflexive thematic analyses within and across the phases identified three higher-order themes.ResultsProgram Participation included barriers, facilitators, sources of motivation and suggested modifications to optimize the program; Biopsychosocial Changes highlighted perceived physical, psychological, and social outcomes, by self and others, that resulted from program participation; PA Autonomy emphasized transitions in knowledge, sex- and gender-related beliefs, and abilities related to exercise and sport participation.ConclusionsStudy findings suggest the TBI-Health program can increase autonomy for and reduce barriers to PA for adults with moderate-to-severe TBI, which results in increased PA participation and important physical, psychological, and social benefits. More research is needed about the TBI-Health program with larger samples

Exploring the facilitators and barriers to shopping mall use by persons with disabilities and strategies for improvements: Perspectives from persons with disabilities, rehabilitation professionals and shopkeepers

AbstractPersons with disabilities face challenges which impact on their ability to accomplish daily activities such as moving around, communicating and fulfilling social roles. Social participation assumes individuals with disabilities live within their community and interact with others. Shopping malls are public spaces used by individuals for various reasons. Here, all components of the social and physical environment interact and have an impact on social participation. This exploratory and qualitative study provides a multi-perspective assessment of the usability, as well as of the environmental facilitators and obstacles to social participation in shopping malls. The results also suggest necessary improvements. We interviewed 15 persons with disabilities, 15 rehabilitation professionals and 9 shopkeepers. Participants viewed the mall as a multifunctional place for everyday use, but at times, also as a limiting place. Multiple facilitators and obstacles were identified; the most important were interaction with shopkeepers and the mall's design for mobility or wayfinding. All participants agreed shopkeeper training and an improved awareness of the needs of persons with disabilities would be beneficial. Multiple stakeholders’ perceptions provide a basis for further investigation about needed changes and their potential for making malls more welcoming and inclusive to all

Creating a rehabilitation living lab to optimize participation and inclusion for persons with physical disabilities

AbstractWe present an on-going multidisciplinary and multisectorial strategic development project put forth by the Centre for Interdisciplinary Research in Rehabilitation of greater Montréal (CRIR) in Quebec, Canada and its members, in collaboration with a Montréal “renovation-ready” shopping mall, local community organizations, and local, national and international research and industrial partners. Beginning in 2011, within the context of the Mall as Living Lab (MALL), more than 45 projects were initiated to: (1) identify the environmental, physical and social obstacles and facilitators to participation; (2) develop technology and interventions to optimize physical and cognitive function participation and inclusion; (3) implement and evaluate the impact of technology and interventions in vivo. Two years later and working within a participatory action research (PAR) approach, and the overarching WHO framework of the International Classification of Functioning, Disability and Health (ICF), we discuss challenges and future endeavors. Challenges include creating and maintaining partnerships, ensuring a PAR approach to engage multiple stakeholders (e.g. people with disabilities, rehabilitation and design researchers, health professionals, community members and shopping mall stakeholders) and assessing the overall impact of the living lab. Future endeavors, including the linking between research results and recommendations for renovations to the mall, are also presented

Recommendations for the use of common outcome measures in pediatric traumatic brain injury research

This article addresses the need for age-relevant outcome measures for traumatic brain injury (TBI) research and summarizes the recommendations by the inter-agency Pediatric TBI Outcomes Workgroup. The Pediatric Workgroup\u27s recommendations address primary clinical research objectives including characterizing course of recovery from TBI, prediction of later outcome, measurement of treatment effects, and comparison of outcomes across studies. Consistent with other Common Data Elements (CDE) Workgroups, the Pediatric TBI Outcomes Workgroup adopted the standard three-tier system in its selection of measures. In the first tier, core measures included valid, robust, and widely applicable outcome measures with proven utility in pediatric TBI from each identified domain including academics, adaptive and daily living skills, family and environment, global outcome, health-related quality of life, infant and toddler measures, language and communication, neuropsychological impairment, physical functioning, psychiatric and psychological functioning, recovery of consciousness, social role participation and social competence, social cognition, and TBI-related symptoms. In the second tier, supplemental measures were recommended for consideration in TBI research focusing on specific topics or populations. In the third tier, emerging measures included important instruments currently under development, in the process of validation, or nearing the point of published findings that have significant potential to be superior to measures in the core and supplemental lists and may eventually replace them as evidence for their utility emerges

Development, implementation, and evaluation of the Apollo model of pediatric rehabilitation service delivery

This article presents the experience of a rehabilitation program that un- dertook the challenge to reorganize its services to address accessibility issues and im- prove service quality. The context in which the reorganization process occurred, along with the relevant literature justifying the need for a new service delivery model, and an historical perspective on the planning; implementation; and evaluation phases of the process are described. In the planning phase, the constitution of the working committee, the data collected, and the information found in the literature are presented. Apollo, the new service delivery model, is then described along with each of its components (e.g., community, group, and individual interventions). Actions and lessons learnt during the implementation of each component are presented. We hope by sharing our experiences that we can help others make informed decisions about service reorganization to im- prove the quality of services provided to children with disabilities, their families, and their communities