Exploring implementation of 24-hour postural management programmes
Research type
Research Study
Full title
Exploring the barriers and enablers, from the perspective of caregivers, in implementing 24-hour postural management programmes within the home.
IRAS ID
242714
Contact name
Lisa Bunn
Contact email
Sponsor organisation
University of Plymouth
Duration of Study in the UK
0 years, 10 months, 29 days
Research summary
This study explores the enablers and barriers, from the perspective of caregivers supporting adults with Profound and Multiple Learning Disabilities (PMLD), in delivering a 24-hour postural management programme. Adults with PMLD are among the most disabled individuals in our community. They have a profound learning disability, with an estimated intelligence quotient below 20. This means that understanding is severely limited posing significant barriers in communication and comprehension. For this reason, the adult caregiver experience seems a pragmatic population to explore, whilst acknowledging the biases of this second-hand perspective.
Current literature within this field focuses on children. Despite some transferability, it could be theorised that barriers/enablers of postural management could be significantly different for the adult populations. Where communication and comprehension barriers exist for adults with PMLD, gold-standard first account experiences of postural management are restricted in feasibility. For this reason, the adult caregiver experience seems a pragmatic population to explore, whilst acknowledging the biases of this second-hand perspective.
A qualitative study will employ semi-structured interviews to optimise exploration of themes, given the relative deficiency of known barriers/enablers of postural management in the existing literature. Study participants will be recruited through the local NHS trust using purposeful sampling strategies, including both paid and informal caregivers, to achieve maximum variation. A framework analysis approach will be used to organise, classify and evaluate key themes emerging from the data. Findings will be used to inform an action plan to direct local clinical practice.
From clinical experience there are some anticipated themes emerging from discussion. Enablers may include training, clear documentation and regular physiotherapy support. Whereas, barriers may focus on complex physical health needs, staffing and experience. However, there are likely to be significant variations in experience, priorities and drivers between paid and informal caregivers for potential sub-analysis.
Understanding the factors impacting on delivering interventions will allow physiotherapists to modify their practice to enhance caregiver engagement. This could in turn reduce costs associated with secondary complications, improve quality of life, ensure equipment and therapy input is used to its best effect.
REC name
Wales REC 7
REC reference
18/WA/0197
Date of REC Opinion
26 Jun 2018
REC opinion
Further Information Favourable Opinion