abstract: 'BackgroundBenign paroxysmal positional vertigo (BPPV) is a common

  presentation to the ED. Evidence suggests low adherence to

  guideline-recommended care, but the reasons underlying this are poorly

  understood. This study used the theoretical domains framework (TDF) to

  explore the barriers and facilitators to medical and physiotherapy

  clinical practices in the management of BPPV in an Australian

  metropolitan ED. MethodsFrom May to December 2021, semistructured

  interviews were conducted with 13 medical staff and 13 physiotherapists

  who worked at an ED in Melbourne, Australia. Interviews used the TDF to

  explore the perceived barriers and facilitators to the delivery of

  guideline-recommended assessment and treatment techniques for BPPV. Data

  were analysed thematically to identify relevant domains and generate

  themes and belief statements. ResultsFifteen belief statements

  representing eight domains of the TDF were identified as key factors in

  the management of BPPV in the ED. The most prominent domains were

  knowledge and skills due to their conflicting belief statements between

  professions concerning education, skill development and self-confidence;

  memory, attention and decision processes for the perceived complexity of

  the presentation including difficulty recalling diagnostic and treatment

  techniques; and environmental context and resources for their shared

  belief statements concerning time and workload pressures. The

  availability of vestibular physiotherapy was considered both a barrier

  and facilitator to the delivery of recommended care by medical staff,

  but a barrier to independent practice as it unintentionally limited the

  opportunities for skill development in medical staff. ConclusionSeveral

  modifiable barriers and facilitators to the management of BPPV in the ED

  have been identified. Differences were observed between the professional

  groups, and these findings will guide a future intervention to improve

  the use of guideline-recommended assessment and treatment techniques for

  BPPV in ED.'
affiliation: 'Bradshaw, S (Corresponding Author), Alfred Hlth, Physiotherapy Dept,
  Melbourne, Vic 3004, Australia.

  Bradshaw, S (Corresponding Author), Alfred Hlth, Emergency Dept, Melbourne, Vic
  3004, Australia.

  Bradshaw, Sally, Alfred Hlth, Emergency \& Trauma Ctr, Melbourne, Vic, Australia.

  Bradshaw, Sally, La Trobe Univ, Sch Allied Hlth, Bundoora Campus, Melbourne, Vic,
  Australia.

  Bradshaw, Sally; Graco, Marnie; Holland, Anne, Alfred Hlth, Physiotherapy Dept,
  Melbourne, Vic 3004, Australia.

  Graco, Marnie; Holland, Anne, Austin Hlth, Inst Breathing \& Sleep, Heidelberg,
  Vic, Australia.

  Graco, Marnie, Univ Melbourne, Sch Hlth Sci, Dept Physiotherapy, Melbourne, Vic,
  Australia.

  Holland, Anne, Monash Univ, Cent Clin Sch, Resp Res, Melbourne, Vic, Australia.

  Bradshaw, Sally, Alfred Hlth, Emergency Dept, Melbourne, Vic 3004, Australia.'
author: Bradshaw, Sally and Graco, Marnie and Holland, Anne
author-email: s.bradshaw@alfred.org.au
author_list:
- family: Bradshaw
  given: Sally
- family: Graco
  given: Marnie
- family: Holland
  given: Anne
da: '2023-09-28'
doi: 10.1136/emermed-2022-212585
earlyaccessdate: FEB 2023
eissn: 1472-0213
files: []
issn: 1472-0205
journal: EMERGENCY MEDICINE JOURNAL
keywords: 'qualitative research; clinical management; guideline; emergency

  department'
keywords-plus: EMERGENCY-DEPARTMENT
language: English
month: 2023 FEB 15
number-of-cited-references: '30'
papis_id: b2288c139c0c8a083ed91b71b38b8e9b
ref: Bradshaw2023barriersfacilitators
times-cited: '1'
title: 'Barriers and facilitators to guideline-recommended care of benign paroxysmal
  positional vertigo in the ED: a qualitative study using the theoretical domains
  framework'
type: Article; Early Access
unique-id: WOS:000934568500001
usage-count-last-180-days: '0'
usage-count-since-2013: '0'
web-of-science-categories: Emergency Medicine
year: '2023'