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Barriers to and facilitators for the use of an evidence‐based occupational therapy guideline for older people with dementia and their carers
Author(s) -
Van't Leven Netta,
Graff Maud J.L.,
Kaijen Marleen,
de Swart Bert J.M.,
Olde Rikkert Marcel G.M.,
VernooijDassen Myrra J.M.
Publication year - 2012
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.2782
Subject(s) - guideline , dementia , reimbursement , grounded theory , nursing , focus group , medicine , occupational therapy , qualitative research , evidence based practice , psychology , health care , family medicine , alternative medicine , physical therapy , disease , social science , business , pathology , marketing , sociology , economics , economic growth
Objective Implementing evidence‐based guidelines is not a simple task. This study aimed to define barriers to and facilitators for implementing the proven and effective Community Occupational Therapy in Dementia (COTiD) guideline for older people with dementia and their carers. Methods The qualitative method we used was the grounded theory. We collected data from focus group interviews with 17 occupational therapists (OTs) and telephone interviews with 10 physicians and 4 managers. We analysed the data with the constant comparative method by identifying codes, categories, and main themes. Results The main themes in barriers that OTs encountered were that they did not feel competent in treating older people with dementia at home according to the guideline; they had difficulties prioritising in this complex treatment, both for the client and themselves; and they were unsure about the minimal criteria for guideline adherence. The intensity of this programme was the main barrier. The barriers that confronted physicians and managers were lack of knowledge about occupational therapy and its reimbursement and lack of available trained OTs. For the OTs, the guideline's content and focus, evidence, and external support facilitated the use of the guideline. For physicians and managers, the guideline's evidence base and its benefits for clients and carers were the main facilitators. Conclusions This study generates knowledge for applying innovations in health care settings. Improvement of the OTs' knowledge and self‐confidence is needed for using the guideline. We expect that more competent OTs will motivate their physicians and managers to use this successful COTiD intervention. Copyright © 2011 John Wiley & Sons, Ltd.