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      How Can We Use the Promoting Action on Research in Health Services (PARIHS) Framework to Move from What We Know to What We Should Do for the Rehabilitation of a Painful Hemiplegic Shoulder (PHS)?

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          Abstract

          Introduction

          Several theoretical frameworks currently promote the evidence-based clinical practice. One of these is Promoting Action on Research Implementation in Health Services (PARIHS) framework. However, The PARIHS framework emphasizes the use and implementation of pre-existing knowledge. This study aims to integrate of PARIHS conceptual framework to categorize evidence, context, and facilitation elements for the successful implementation of evidence-based painful hemiplegic shoulder (PHS) rehabilitation.

          Methods

          Stroke therapists (n=21) were interviewed to elicit important PHS rehabilitation concepts. Following that, a consensus approach was undertaken to tailor PHS recommendations to the local context. All consensus recommendations have been included in the PARIHS framework. The consensus level was set at 75% or more.

          Results

          The interviews revealed four broad themes of PHS rehabilitation, each further subdivided. Based on the themes and subthemes, 74 recommendations were deemed pertinent to PSH rehabilitation from a reliable source. Out of 74 recommendations, 63 recommendations reach the consensus level for PHS practice. Secondary prevention of PHS (n=10), assessment (n=14), PHS care management (n=19), and service delivery (n=20). A consensus was not reached for the remaining 11 recommendations. Each recommended guideline was integrated into the appropriate element of the PARIHS framework as follows: evidence (28), context (18), and facilitation (17).

          Discussion

          The findings showed how the PARIHS framework has been configured to empirically support the implementation of robust stroke rehabilitation recommendations in the field of rehabilitation. Using an implementation intervention theory (for example, PARIHS) as a guide, provide a thorough picture of the many levels that may affect implementation requirements.

          Conclusion

          Many prior studies on evidence-based stroke rehabilitation in physical therapy practice lacked knowledge of translation theories. This result illustrates how to use an intervention implementation (such as PARIHS) to enhance evidence-based practice implementation in routine stroke rehabilitation. Further study is required for the clinical use of the PARIHS framework.

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          Using thematic analysis in psychology

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            Evaluating the successful implementation of evidence into practice using the PARiHS framework: theoretical and practical challenges

            Background The PARiHS framework (Promoting Action on Research Implementation in Health Services) has proved to be a useful practical and conceptual heuristic for many researchers and practitioners in framing their research or knowledge translation endeavours. However, as a conceptual framework it still remains untested and therefore its contribution to the overall development and testing of theory in the field of implementation science is largely unquantified. Discussion This being the case, the paper provides an integrated summary of our conceptual and theoretical thinking so far and introduces a typology (derived from social policy analysis) used to distinguish between the terms conceptual framework, theory and model – important definitional and conceptual issues in trying to refine theoretical and methodological approaches to knowledge translation. Secondly, the paper describes the next phase of our work, in particular concentrating on the conceptual thinking and mapping that has led to the generation of the hypothesis that the PARiHS framework is best utilised as a two-stage process: as a preliminary (diagnostic and evaluative) measure of the elements and sub-elements of evidence (E) and context (C), and then using the aggregated data from these measures to determine the most appropriate facilitation method. The exact nature of the intervention is thus determined by the specific actors in the specific context at a specific time and place. In the process of refining this next phase of our work, we have had to consider the wider issues around the use of theories to inform and shape our research activity; the ongoing challenges of developing robust and sensitive measures; facilitation as an intervention for getting research into practice; and finally to note how the current debates around evidence into practice are adopting wider notions that fit innovations more generally. Summary The paper concludes by suggesting that the future direction of the work on the PARiHS framework is to develop a two-stage diagnostic and evaluative approach, where the intervention is shaped and moulded by the information gathered about the specific situation and from participating stakeholders. In order to expedite the generation of new evidence and testing of emerging theories, we suggest the formation of an international research implementation science collaborative that can systematically collect and analyse experiences of using and testing the PARiHS framework and similar conceptual and theoretical approaches. We also recommend further refinement of the definitions around conceptual framework, theory, and model, suggesting a wider discussion that embraces multiple epistemological and ontological perspectives.
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              The PARIHS framework--a framework for guiding the implementation of evidence-based practice.

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                Author and article information

                Journal
                J Multidiscip Healthc
                J Multidiscip Healthc
                jmdh
                Journal of Multidisciplinary Healthcare
                Dove
                1178-2390
                14 December 2022
                2022
                : 15
                : 2831-2843
                Affiliations
                [1 ]Department of Physical Therapy, Faculty of Applied Medical Sciences, University of Tabuk , Tabuk City, Kingdom of Saudi Arabia
                Author notes
                Correspondence: Salem F Alatawi, Email sfalatawi@ut.edu.sa
                Author information
                http://orcid.org/0000-0003-2187-2628
                Article
                392376
                10.2147/JMDH.S392376
                9760074
                36540858
                0e979885-eceb-43c3-a954-35c0be03cb36
                © 2022 Alatawi.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 06 October 2022
                : 06 December 2022
                Page count
                Figures: 3, Tables: 2, References: 30, Pages: 13
                Categories
                Original Research

                Medicine
                implementation,parihs framework,knowledge translation,stroke,hemiplegic shoulder,rehabilitation and clinical guidelines

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