2023-09-28 14:46:10 +00:00
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abstract: 'BackgroundBenign paroxysmal positional vertigo (BPPV) is a common
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presentation to the ED. Evidence suggests low adherence to
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guideline-recommended care, but the reasons underlying this are poorly
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understood. This study used the theoretical domains framework (TDF) to
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explore the barriers and facilitators to medical and physiotherapy
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clinical practices in the management of BPPV in an Australian
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metropolitan ED. MethodsFrom May to December 2021, semistructured
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interviews were conducted with 13 medical staff and 13 physiotherapists
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who worked at an ED in Melbourne, Australia. Interviews used the TDF to
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explore the perceived barriers and facilitators to the delivery of
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guideline-recommended assessment and treatment techniques for BPPV. Data
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were analysed thematically to identify relevant domains and generate
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themes and belief statements. ResultsFifteen belief statements
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representing eight domains of the TDF were identified as key factors in
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the management of BPPV in the ED. The most prominent domains were
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knowledge and skills due to their conflicting belief statements between
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professions concerning education, skill development and self-confidence;
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memory, attention and decision processes for the perceived complexity of
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the presentation including difficulty recalling diagnostic and treatment
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techniques; and environmental context and resources for their shared
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belief statements concerning time and workload pressures. The
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availability of vestibular physiotherapy was considered both a barrier
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and facilitator to the delivery of recommended care by medical staff,
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but a barrier to independent practice as it unintentionally limited the
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opportunities for skill development in medical staff. ConclusionSeveral
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modifiable barriers and facilitators to the management of BPPV in the ED
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have been identified. Differences were observed between the professional
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groups, and these findings will guide a future intervention to improve
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the use of guideline-recommended assessment and treatment techniques for
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BPPV in ED.'
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affiliation: 'Bradshaw, S (Corresponding Author), Alfred Hlth, Physiotherapy Dept,
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Melbourne, Vic 3004, Australia.
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Bradshaw, S (Corresponding Author), Alfred Hlth, Emergency Dept, Melbourne, Vic
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3004, Australia.
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Bradshaw, Sally, Alfred Hlth, Emergency \& Trauma Ctr, Melbourne, Vic, Australia.
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Bradshaw, Sally, La Trobe Univ, Sch Allied Hlth, Bundoora Campus, Melbourne, Vic,
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Australia.
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Bradshaw, Sally; Graco, Marnie; Holland, Anne, Alfred Hlth, Physiotherapy Dept,
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Melbourne, Vic 3004, Australia.
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Graco, Marnie; Holland, Anne, Austin Hlth, Inst Breathing \& Sleep, Heidelberg,
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Vic, Australia.
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Graco, Marnie, Univ Melbourne, Sch Hlth Sci, Dept Physiotherapy, Melbourne, Vic,
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Australia.
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Holland, Anne, Monash Univ, Cent Clin Sch, Resp Res, Melbourne, Vic, Australia.
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Bradshaw, Sally, Alfred Hlth, Emergency Dept, Melbourne, Vic 3004, Australia.'
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author: Bradshaw, Sally and Graco, Marnie and Holland, Anne
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author-email: s.bradshaw@alfred.org.au
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author_list:
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- family: Bradshaw
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given: Sally
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- family: Graco
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given: Marnie
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- family: Holland
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given: Anne
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da: '2023-09-28'
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doi: 10.1136/emermed-2022-212585
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earlyaccessdate: FEB 2023
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eissn: 1472-0213
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files: []
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issn: 1472-0205
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journal: EMERGENCY MEDICINE JOURNAL
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keywords: 'qualitative research; clinical management; guideline; emergency
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department'
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keywords-plus: EMERGENCY-DEPARTMENT
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language: English
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month: 2023 FEB 15
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number-of-cited-references: '30'
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papis_id: b2288c139c0c8a083ed91b71b38b8e9b
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ref: Bradshaw2023barriersfacilitators
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times-cited: '1'
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title: 'Barriers and facilitators to guideline-recommended care of benign paroxysmal
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positional vertigo in the ED: a qualitative study using the theoretical domains
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framework'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000934568500001
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usage-count-last-180-days: '0'
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usage-count-since-2013: '0'
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web-of-science-categories: Emergency Medicine
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year: '2023'
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