Perspectives from clinicians and managers: facilitators and barriers to the uptake of rehabilitation guidance for children with arthrogryposis

PurposeTo identify the perceived facilitators and barriers among clinicians and managers about the uptake of expert guidance for rehabilitation of children with arthrogryposis multiplex congenita (AMC) in practice.MethodsQualitative study using individual interviews, guided by the Theoretical Domains Framework (TDF), to explore beliefs and to identify facilitators and barriers to guidance uptake. Interviews were conducted with a convenience sample of 15 clinicians working with children with AMC and four pediatric clinical managers using Microsoft Teams (c). Interviews were then transcribed verbatim and analyzed by four independent reviewers using deductive and inductive coding.ResultsThe TDF domains of Environmental Context and Resources, Behavioural Regulation, Reinforcement, Beliefs about Consequences, and Social Influences were shared amongst clinicians and clinical managers across North America and Europe as being relevant and influential on the target behaviour of using rehabilitation expert guidance to manage pediatric patients. Among clinicians only, the domain Memory, Attention, and Decision-Making Processes was also found relevant. Among managers only, the domain Social/Professional Role and Identity was found relevant.ConclusionsCoupling shared relevant domains amongst clinicians and managers with individual supports and barriers helps to map out what is needed to promote the uptake of rehabilitation guidance at multiple levels. The uptake of expert guidance is helpful for rehabilitation professionals to align best practice with expert opinion based on clinicians and lived experience for a condition as rare as arthrogryposis multiplex congenita (AMC).In order to facilitate the uptake of guidance, rehabilitation professionals and clinical managers need to collaborate during the development and uptake in practice.Rehabilitation professionals require support for the uptake of guidance, such as training, regular team encounters, and a knowledge broker.Rehabilitation professionals and clinical managers should be aware of identified facilitators and barriers to the uptake of guidance, such as time, clinical resources, and accessibility.

Automated summary

The study aims to identify the facilitators and barriers to the uptake of expert guidance for rehabilitation of children with arthrogryposis multiplex congenita (AMC) among clinicians and managers. Through qualitative interviews and analysis using the Theoretical Domains Framework (TDF), the study reveals the shared relevant domains and individual factors influencing the uptake of guidance. The findings highlight the importance of collaboration, support, and awareness of facilitators and barriers for promoting the uptake of rehabilitation guidance.