Using Implementation Science to Guide the Process of Adapting a Patient Engagement Intervention for Inpatient Spinal Cord Injury/Disorder Rehabilitation.
Ryan J Walsh, Virginia R McKay, Piper E Hansen and 8 others
PMID 35588857WHAT IT FOUND
Clinicians and a patient advocate adapted an engagement intervention for spinal cord injury rehab.
They changed goal-setting cards and trackers to fit therapy sessions but kept core principles like letting the patient choose goals.
Key findings
01The adaptation process involved 5 meetings with 7 stakeholders (3 OTs, 2 PTs, 1 physiatrist, 1 patient advocate) to modify an existing intervention.
02Core principles of 'patient as boss' and linking activities to goals were kept unchanged, while materials like goal cards and therapy trackers were modified for spinal cord injury relevance.
03The study did not test if the adapted intervention improved patient outcomes, only that it was modified for feasibility.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was descriptive and did not test whether the adapted intervention actually improved patient outcomes or feasibility. Only 7 stakeholders participated in the adaptation process. The single patient advocate involved had a high level of function and extensive research experience, which may not represent the broader patient population. The adaptation focused only on OT and PT services, excluding other disciplines like speech therapy. Budget constraints limited the process to 5 meetings, which may have been insufficient time to evaluate all components thoroughly.
Declared interests
The study was supported by NIH, U.S. Government, and non-U.S. government grants. Two research team members had previously served as the trainer and PI in the original E-MR study, which may introduce bias in how the intervention was adapted.
The easy way to misread this
Do not assume this adapted intervention has been proven to improve patient outcomes or engagement levels. The paper describes the process of modifying the tools for a specific setting but explicitly states it explored neither association nor causation between the adapted intervention and patient results.