Essay Example on Clinicians Identified Several Potential Barriers to the Successful Delivery








The clinicians who participated in this study were part of an interdisciplinary program and attended a 2-day workshop on self-management support using the BAP Despite this the results of this study showed that the clinicians identified several potential barriers to the successful delivery self-management support in clinical practice The barriers uncovered in this study are in line with previous findings Michael Vallis 2015 found that the main challenges to delivering self-management of chronic diseases in a clinical setting included lack of training and competence and lack of time among clinicians 30 Also a Jeffery et al 2013 study indicated that lack of experience and time were barriers among clinicians for patient health coaching 29 Lastly clinicians in this study considered patients perspective as a barrier to delivering self-management support This might be related to clinicians fear of shifting away from a traditional practice and the discrepancy in the perception between clinicians and patients 28 Patients view was a unique barrier to deliver self-management support in clinical practice in this study

On the other hand, there were some enablers identified by participants that could facilitate the delivery of self-management support when managing individuals with LBP in a clinical setting such as having sufficient knowledge and confidence on this topic This finding, however, contradicts findings of two other studies Michael Vallis 2015 and Effery Ervin 2014 showed that clinicians did not have sufficient knowledge and confidence to deliver self-management support 29 30 These contrasting findings might be because our study's participants attended a 2-day self-management workshop which likely increased their knowledge and improved their confidence The participants in our study were also motivated to deliver self-management This might be related to their beliefs that the BAP is an effective self-management approach the collaboration of team members and the support from managers Furthermore clinicians in the current study stated that they would keep delivering self-management support in clinical practice if it improved patients health outcomes i e reinforcement This is congruent with the operant learning theory where the achievements of a behavior determines the continued use of that behavior in the future 42 The expert panel suggested KT intervention components based on behavior change techniques to address the identified barriers to delivering self-management support

The main KT intervention components were selected based on the existing evidence 53 and feasibility to be implemented in the respective clinical settings educational and training workshop opinion leader webinar and video educational instructional materials and BAP model algorithm poster The effectiveness of educational meetings alone or combined with other intervention components on the clinicians practice is supported by a high-quality review 54 Other three high-quality reviews show that educational meetings have mixed results regarding the improvement of clinicians practices 55 58 Furthermore the effectiveness of using educational materials to improve healthcare providers practice was supported by two high-quality reviews 59 60 Lastly the effectiveness of an opinion leader was supported by a high-quality review 61 opinion leader intervention either alone or combined with other interventions improves the clinicians practices The KT intervention presented in this paper will form a multi-faceted intervention which is more effective than a single intervention It has been shown in the literature that multifaceted interventions address a bigger number of gaps and barriers 62, In turn, this potentially has a positive impact on increasing the clinicians knowledge and fostering best practices 63 64

The self-management intervention identified in this study is organized and guided by the BAP framework Studies have found that a well-structured self-management intervention positively impacts the health outcomes among patients 65 The development of theory based KT interventions aimed to address the barriers to delivering self-management support in treating individuals with LBP in a clinical setting may help clinicians effect changes in their practices to allow them to confidently deliver self-management support and to actively engage patients in their own care This may help clinical teams provide optimal health care for individuals with LBP which may, in turn, reduce pain interference optimize functional ability and quality of life and decrease costs 27 Strength Limitation To the best of our knowledge this is the first study studying at the barriers to the delivery of self-management support in LBP according to interdisciplinary clinicians perception This paper also developed KT strategies to optimize the uptake of self-management in clinical practice The multi faceted intervention developed in this study is theory driven with a systematic approach This, in turn, strengthens the process of selection of the different intervention components Nevertheless limitations arose in this study The positive results of this study cannot be generalized to the province of Quebec given that the data collection occurred at four clinical sites Also the sample size of this study was small which brings about another limitation Conclusion

 The Theoretical Domain Framework was a useful framework to identify factors that influenced the delivery of self-management support to individuals with LBP and that need to be addressed in KT interventions which included clinician skills social influence and environmental context and resources Mapping these to behavior change techniques resulted in a multicomponent KT intervention that was designed based on the evidence and feasibility to overcome the identified barriers and maximize the delivery of self-management support in LBP clinics In light of the above-mentioned information the KT intervention in changing clinicians behavior toward the uptake of self-management support requires further testing

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