title: Determining the barriers and facilitators to adopting best practices in the management of poststroke unilateral spatial neglect: results of a qualitative study.
abstract: BACKGROUND
  A gap exists between best and actual management of poststroke unilateral spatial neglect (USN). Given the negative impact of USN on poststroke recovery, knowledge translation efforts are needed to optimize USN management. To date, no study has investigated the specific barriers and facilitators affecting USN management during the acute care process.
  
  
  OBJECTIVE
  To identify the facilitators and barriers that affect evidence-based practice use by occupational therapists (the primary discipline managing USN) when treating individuals with acute poststroke USN.
  
  
  METHODS
  Focus group methodology elicited information from 9 acute care occupational therapists.
  
  
  RESULTS
  Key barriers identified included lack of basic evidence-based practice skills specific to USN treatment and personal motivation to change current practices and engrained habits. Key facilitators included the presence of a multidisciplinary stroke team, recent graduation, and an environment with access to learning time and resources. Synthesized Web-based learning was also seen as important to uptake of best practices.
  
  
  CONCLUSIONS
  It is estimated that upwards of 40% of patients experience poststroke USN in the acute phase, and we have evidence of poor early management. This study identified several modifiable factors that prepare the ground for the creation and testing of a multimodal knowledge translation intervention aimed at improving clinicians' best practice management of poststroke USN.
authors.affiliation: School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Canada Royal Victoria Hospital, McGill University Health Center, Montreal, Canada.
authors.forename: Anita
authors.initials: A
authors.lastname: Petzold
authors.affiliation: School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Canada Centre de recherche interdisciplinaire en réadaptation du Montréal Métropolitain, Montreal, Canada.
authors.forename: Nicol
authors.initials: N
authors.lastname: Korner-Bitensky
authors.affiliation: Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada.
authors.forename: Nancy M
authors.initials: NM
authors.lastname: Salbach
authors.affiliation: School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Canada Centre de recherche interdisciplinaire en réadaptation du Montréal Métropolitain, Montreal, Canada.
authors.forename: Sara
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Canada Department of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, Canada.
authors.forename: Anita
authors.initials: A
authors.lastname: Menon
authors.affiliation: Montreal Neurological Institute, Montreal University Health Center, Montreal, Canada.
authors.forename: Tatiana
authors.initials: T
authors.lastname: Ogourtsova
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D019468:Disease Management; D055317:Evidence-Based Practice / Q000592:standards*; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009788:Occupational Therapy / Q000592:standards*; D010468:Perceptual Disorders / Q000209:etiology / Q000534:rehabilitation*; D036301:Qualitative Research; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D000078329:Workforce; D055815:Young Adult
keywords: evidence-based practice; focus groups; hemispatial neglect; occupational therapy; stroke