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Health care professionals’ views of the factors influencing the decision to refer patients to a stroke rehabilitation trial
BACKGROUND: Effective recruitment is an essential element of successful research but notoriously difficult to achieve. This article examines health care professionals’ views on the factors influencing decision-making regarding referral to a stroke rehabilitation trial. METHODS: Semi-structured inter...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4683768/ https://www.ncbi.nlm.nih.gov/pubmed/26680020 http://dx.doi.org/10.1186/s13063-015-1115-1 |
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author | Thomas, Nessa Plant, Sarah Woodward-Nutt, Kate Prior, Yeliz Tyson, Sarah |
author_facet | Thomas, Nessa Plant, Sarah Woodward-Nutt, Kate Prior, Yeliz Tyson, Sarah |
author_sort | Thomas, Nessa |
collection | PubMed |
description | BACKGROUND: Effective recruitment is an essential element of successful research but notoriously difficult to achieve. This article examines health care professionals’ views on the factors influencing decision-making regarding referral to a stroke rehabilitation trial. METHODS: Semi-structured interviews and a card-sorting task were undertaken with stroke service staff in acute and community hospital trusts. Data analysis used a thematic framework approach. RESULTS: Twenty-seven qualified health care professionals from 12 (6 acute and 6 community) hospital trusts and one charity participated. Four main factors emerged: patient-related, professional views, the organisation and research logistics, which all contributed to staff’s decision about whether to refer patients to a trial. Clinicians identified patient-related factors as the most frequent influence and considered themselves the patients’ advocate. They used their knowledge of the patient to anticipate the patients’ reaction to possible participation and tended to only refer those whom they perceived would respond positively. Participants also identified experience of research, a sense of ownership of the project and a positive view of the intervention being evaluated as factors influencing referral. The need to prioritise clinical matters, meet managerial demands and cope with constant change were organisational factors impacting negatively on referral. Staff often simply forgot about recruitment in the face of other higher priorities. Quick, simple, flexible research processes that were closely aligned with existing ways of working were felt to facilitate recruitment. CONCLUSIONS: Patient- and professional-related factors were the most frequent influence on clinicians’ recruitment decisions, which often had a ‘gate-keeping’ effect. Managerial and clinical responsibility to juggle multiple (often higher) priorities was also an important factor. To facilitate recruitment, researchers need to develop strategies to approach potential participants as directly as possible to enable them to make their own decisions about participation; ensure that research processes are as quick and simple as possible; align with existing clinical pathways and systems; and give regular reminders and ongoing support to promote recruitment. TRIAL REGISTRATION: ISRCTN, 98287938. Registered 6 May 2015 ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13063-015-1115-1) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-4683768 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-46837682015-12-19 Health care professionals’ views of the factors influencing the decision to refer patients to a stroke rehabilitation trial Thomas, Nessa Plant, Sarah Woodward-Nutt, Kate Prior, Yeliz Tyson, Sarah Trials Research BACKGROUND: Effective recruitment is an essential element of successful research but notoriously difficult to achieve. This article examines health care professionals’ views on the factors influencing decision-making regarding referral to a stroke rehabilitation trial. METHODS: Semi-structured interviews and a card-sorting task were undertaken with stroke service staff in acute and community hospital trusts. Data analysis used a thematic framework approach. RESULTS: Twenty-seven qualified health care professionals from 12 (6 acute and 6 community) hospital trusts and one charity participated. Four main factors emerged: patient-related, professional views, the organisation and research logistics, which all contributed to staff’s decision about whether to refer patients to a trial. Clinicians identified patient-related factors as the most frequent influence and considered themselves the patients’ advocate. They used their knowledge of the patient to anticipate the patients’ reaction to possible participation and tended to only refer those whom they perceived would respond positively. Participants also identified experience of research, a sense of ownership of the project and a positive view of the intervention being evaluated as factors influencing referral. The need to prioritise clinical matters, meet managerial demands and cope with constant change were organisational factors impacting negatively on referral. Staff often simply forgot about recruitment in the face of other higher priorities. Quick, simple, flexible research processes that were closely aligned with existing ways of working were felt to facilitate recruitment. CONCLUSIONS: Patient- and professional-related factors were the most frequent influence on clinicians’ recruitment decisions, which often had a ‘gate-keeping’ effect. Managerial and clinical responsibility to juggle multiple (often higher) priorities was also an important factor. To facilitate recruitment, researchers need to develop strategies to approach potential participants as directly as possible to enable them to make their own decisions about participation; ensure that research processes are as quick and simple as possible; align with existing clinical pathways and systems; and give regular reminders and ongoing support to promote recruitment. TRIAL REGISTRATION: ISRCTN, 98287938. Registered 6 May 2015 ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13063-015-1115-1) contains supplementary material, which is available to authorized users. BioMed Central 2015-12-18 /pmc/articles/PMC4683768/ /pubmed/26680020 http://dx.doi.org/10.1186/s13063-015-1115-1 Text en © Thomas et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Thomas, Nessa Plant, Sarah Woodward-Nutt, Kate Prior, Yeliz Tyson, Sarah Health care professionals’ views of the factors influencing the decision to refer patients to a stroke rehabilitation trial |
title | Health care professionals’ views of the factors influencing the decision to refer patients to a stroke rehabilitation trial |
title_full | Health care professionals’ views of the factors influencing the decision to refer patients to a stroke rehabilitation trial |
title_fullStr | Health care professionals’ views of the factors influencing the decision to refer patients to a stroke rehabilitation trial |
title_full_unstemmed | Health care professionals’ views of the factors influencing the decision to refer patients to a stroke rehabilitation trial |
title_short | Health care professionals’ views of the factors influencing the decision to refer patients to a stroke rehabilitation trial |
title_sort | health care professionals’ views of the factors influencing the decision to refer patients to a stroke rehabilitation trial |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4683768/ https://www.ncbi.nlm.nih.gov/pubmed/26680020 http://dx.doi.org/10.1186/s13063-015-1115-1 |
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