Frontline Therapists' Perceptions of Implementing a Novel Rehabilitation Intervention Research Study with Patients in the Intensive Care Unit: A Trinational survey
CCCF ePoster library. Reid J. 11/12/19; 283357; EP83
Dr. Julie Reid
Dr. Julie Reid
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Topic: Survey or Interview (quantitative or qualitative)

Reid, Julie C, MSc PT, PhD Candidate1, McCaskell, Devin, BSc, MMASc Candidate2, Kho, Michelle E, PT, PhD1,2
1Faculty of Health Sciences, School of Rehabilitation Science, McMaster University, Institute of Applied Health Sciences, Room 403, 1400 Main Street West, Hamilton, ON, Canada, L8S 1C7
2Department of Physiotherapy, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton ON, Canada, L8N 4A6

Introduction: Novel interventions such as in-bed cycling are gaining popularity in intensive care unit (ICU) rehabilitation research. Frontline therapists often implement these interventions, however little is known about their perceptions of barriers and facilitators to implementation in the context of research. 
Objective: To understand frontline ICU therapist perceptions of barriers and facilitators to implementing the CYCLE Pilot randomized clinical trial (RCT) (NCT02377830) evaluating early in-bed cycling with mechanically ventilated patients in the ICU and outcome measures (OM).
Methods: Informed by 2 complementary knowledge translation (KT) frameworks, the Capability-Opportunity-Motivation-Behaviour (COM-B) system and the Theoretical Domains Framework (TDF), we developed a 115-item, self-administered, electronic survey. We included 3 sections: Rehabilitation Practice and Research, Cycling and physical OM. Each section contained items related to the COM-B system and TDF, with most questions answered on a 7-point Likert-type scale (1=strongly disagree; 7=strongly agree). We invited therapists who participated in the international, multi-center, CYCLE Pilot RCT to complete this survey. We descriptively analyzed and compared results by section, COM-B attribute, TDF domain, and individual question within and across sections using Kruskal-Wallis tests with Bonferroni corrections. We identified barriers as items with median scores <4/7.
Results: Our response rate was 85% (45/53). Respondents were from Canada (67%), had a physiotherapy background (87%), and previous research experience (87%). Rehabilitation Practice and Research (85%) demonstrated higher scores than Cycling (77%; p<0.001) and OM (78%; p=0.011). Motivation was significantly lower than Capability (p=0.033) and Opportunity (p=0.016) across the sections. The most common Motivation barrier related to time required to conduct cycling and OM (median (1st,3rd quartiles) 3/7 (2,6)). 
Conclusions: Frontline ICU therapists were enthusiastic to participate in CYCLE. However, respondents' reported important Motivation barriers, specifically the time required to implement the research protocol. Our results can inform KT strategies to optimize protocol implementation and therapist engagement in ICU rehabilitation research.

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