Evidence map›Paper›PMID 40200211›Full record

ArticleBMC health services research2025

Exploring factors influencing the consistent adoption of a post-stroke upper extremity outcome measure using Normalisation Process Theory.

Silvana X Choo, Joshua Yong, Shaikh Abdullah Bin Mohamed Rafi, Chen Ju Lo, Jun Bin Tong, Elaine Lum, Julian Thumboo

Abstract read
In one paragraph

Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Silvana X ChooDepartment of Occupational Therapy, Singapore General Hospital, Singapore, Singapore. silvana.choo.xinyi@sgh.com.sg.
Joshua YongDepartment of Occupational Therapy, Sengkang General Hospital, Singapore, Singapore.
Shaikh Abdullah Bin Mohamed RafiDepartment of Occupational Therapy, Singapore General Hospital, Singapore, Singapore.
Chen Ju LoOutram Community Hospital Rehabilitation Services, Singhealth Community Hospitals, Singapore, Singapore.
Jun Bin TongSengkang Community Hospital - Occupational Therapy, Singhealth Community Hospitals, Singapore, Singapore.
Elaine LumHealth Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.
Julian ThumbooDepartment of Rheumatology and Immunology and Health Services Research Unit, Singapore General Hospital, Singapore, Singapore.

Funding

SingHealth Duke-NUS Academic Medicine Research Grant AM\HRT016/2021
6 · The paper itself

Abstract

backgroundStroke rehabilitation guidelines recommend using outcome measures like the Fugl-Meyer Assessment for Upper Extremity (FMA-UE) to assess post-stroke upper extremity function. However, integrating such outcome measures into routine clinical practice remains challenging, highlighting the need to understand factors affecting their implementation in evolving healthcare models.

objectiveOur study aimed to identify the barriers and facilitators to sustain the routine use of the FMA-UE among hospital-based occupational therapists (OTs) using a theory-driven approach.

methodsEmploying a mixed-method sequential exploratory study design rooted in Normalisation Process Theory (NPT), we gathered quantitative data through a validated survey followed by qualitative insights analysed with directed content analysis from focus group discussions involving occupational therapists from four hospitals.

resultsSurvey findings (n = 34) revealed barriers primarily associated with NPT constructs of collective action and coherence. Facilitators were linked to the cognitive participation construct. Key barriers identified in focus groups included insufficient coaching, competing priorities, and perceived limited value of the FMA-UE. Facilitators included legitimation of therapists' role in outcome measurements and an open learning culture.

conclusionsThrough a theory-based approach, we identified barriers and facilitators to sustain the routine of the FMA-UE. Our findings offer insights for designing implementation strategies to embed the FMA-UE into routine practice, supporting its sustained use in stroke rehabilitation.

Indexed as

Occupational TherapyOutcome Assessment, Health CareStroke RehabilitationUpper ExtremityFemaleFocus GroupsHumansMaleOccupational TherapistsQualitative ResearchStrokeFugl-Meyer AssessmentImplementation scienceOutcome measureRehabilitationStrokeUpper limb

Identifiers

PMID40200211
PMCPMC11980167

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.