Anne Hudon | Université de Montréal (original) (raw)
Papers by Anne Hudon
Healthcare Policy, 2015
Musculoskeletal disorders are among the leading causes of work-related physical disability in the... more Musculoskeletal disorders are among the leading causes of work-related physical disability in the province of Quebec in Canada. The authors conducted a focus group study with physiotherapists and physical rehabilitation therapists working with patients whose treatments are compensated by the Quebec Workers' Compensation Board with the goal of exploring quality of care and ethical issues. Three main themes were identified: (1) systemic factors, (2) complexity in treatment decisions and (3) inequality of care. Although physiotherapy professionals strive to give these patients the best possible care, patients might not always be provided with optimal or equal treatment. When compared with other patients, there appear to be differences with respect to access to care and types of services offered to injured workers, raising equity concerns. Factors that shape and constrain quality of physiotherapy services for injured workers need to be addressed to improve care for these patients.
A four-jurisdiction qualitative analysis of workers’ compensation healthcare policies
Safety and Health at Work
Additional file 2: of Physiotherapy for injured workers in Canada: are insurers' and clinics' policies threatening good quality and equity of care? Results of a qualitative study
Summary of key questions asked to leaders and administrators participating in the study. (DOCX 14... more Summary of key questions asked to leaders and administrators participating in the study. (DOCX 147 kb)
Additional file 1: of Physiotherapy for injured workers in Canada: are insurers' and clinics' policies threatening good quality and equity of care? Results of a qualitative study
Summary of key questions asked to clinicians participating in the study. (DOCX 129 kb)
There is growing recognition of the importance of knowledge translation activities in physical th... more There is growing recognition of the importance of knowledge translation activities in physical therapy to ensure that research findings are integrated into clinical practice, and increasing numbers of knowledge translation interventions are being conducted. Although various frameworks have been developed to guide and facilitate the process of translating knowledge into practice, these tools have been infrequently used in physical therapy knowledge translation studies to date. Knowledge translation in physical therapy implicates multiple stakeholders and environments and involves numerous steps. In light of this complexity, the use of explicit conceptual frame-works by clinicians and researchers conducting knowledge translation interventions is associated with a range of potential benefits. This perspective article argues that such frameworks are important resources to promote the uptake of new evidence in physical therapist practice settings. Four key benefits associated with the us...
1 Running head: Contribution of Conceptual Frameworks Knowledge Translation and Implementation Research The Contribution of Conceptual Frameworks to Knowledge Translation Interventions in Physical Therapy
and CJM-IU-UQÀM Chair on knowledge translation in the field of child and family welfare.
Les physiothérapeutes cliniciens-chercheurs : un rôle de pratique avancée trop peu soutenu pour les physiothérapeutes au Canada
Physiotherapy Canada
Physiotherapists as Clinician-Scientists: An Insufficiently Supported Advanced-Practice Physiotherapy Role in Canada
Physiotherapy Canada. Physiotherapie Canada, 2021
What is pain-related suffering? Conceptual critiques, key attributes, and outstanding questions
The Journal of Pain
Les physiothérapeutes cliniciens-chercheurs : un rôle de pratique avancée trop peu soutenu pour les physiothérapeutes au Canada
Physiotherapy Canada. Physiotherapie Canada, 2021
BMC Musculoskeletal Disorders
Background Optimizing patients’ total hip and knee arthroplasty (THA/TKA) experience is as crucia... more Background Optimizing patients’ total hip and knee arthroplasty (THA/TKA) experience is as crucial for providing high quality care as improving safety and clinical effectiveness. Yet, little evidence is available on patient experience in standard-inpatient and enhanced recovery after surgery (ERAS)-outpatient programs. Therefore, this study aimed to gain a more in-depth understanding of the patient experience of ERAS-outpatient programs in comparison to standard-inpatient programs. Methods We conducted a convergent mixed methods study of 48 consecutive patients who experienced both standard-inpatient and ERAS-outpatient THA/TKA contralaterally. A reflective thematic analysis was conducted based on data collected via a questionnaire. Bivariate correlations between the patient experience and patients’ characteristics, clinical outcomes and care components satisfaction were performed. Then, the quantitative and qualitative data were integrated together. Results The theme Support makes ...
Thèse présentée à la Faculté des études supérieures en vue de l'obtention du grade de Philosophia... more Thèse présentée à la Faculté des études supérieures en vue de l'obtention du grade de Philosophiae Doctor (Ph.D.) en Sciences de la réadaptation Mai 2017
Development of a national pain management competency profile to guide entry-level physiotherapy education in Canada
Canadian Journal of Pain
Canadian Journal of Occupational Therapy
Background. Change agents’ actions have been studied mainly from a theoretical perspective. Purpo... more Background. Change agents’ actions have been studied mainly from a theoretical perspective. Purpose. This study aimed to empirically identify occupational therapists’ actual change agent actions. Method. As part of a research partnership with the Canadian Association of Occupational Therapists-Québec chapter, we conducted this cross-sectional pilot study using an online survey. Findings. The change agent practices of our 103 participants involve many types of actions but show underinvestment in mass communication. Mass communication actions are more frequent when participants have greater experience, additional academic degrees, and training in change agency. Also, occupational therapists with additional academic degrees and change agency training tend to use a wider variety of actions. Finally, our participants’ actions principally target actors in the clinical context, rarely political actors. Implications. Our results suggest that occupational therapists can and will invest in th...
Tensions Living Out Professional Values for Physical Therapists Treating Injured Workers
Qualitative Health Research
Health care services provided by workers’ compensation systems aim to facilitate recovery for inj... more Health care services provided by workers’ compensation systems aim to facilitate recovery for injured workers. However, some features of these systems pose barriers to high quality care and challenge health care professionals in their everyday work. We used interpretive description methodology to explore ethical tensions experienced by physical therapists caring for patients with musculoskeletal injuries compensated by Workers’ Compensation Boards. We conducted in-depth interviews with 40 physical therapists and leaders in the physical therapy and workers’ compensation fields from three Canadian provinces and analyzed transcripts using concurrent and constant comparative techniques. Through our analysis, we developed inductive themes reflecting significant challenges experienced by participants in upholding three core professional values: equity, competence, and autonomy. These challenges illustrate multiple facets of physical therapists’ struggles to uphold moral commitments and pr...
BMC Health Services Research
Background: In recent years, significant efforts have been made to improve the provision of care ... more Background: In recent years, significant efforts have been made to improve the provision of care for compensated injured workers internationally. However, despite increasing efforts at implementing best practices in this field, some studies show that policies overseeing the organisation of care for injured workers can have perverse influences on healthcare providers' practices and can prevent workers from receiving the best care possible. The influence of these policies on physiotherapists' practices has yet to be investigated. Our objectives were thus to explore the influence of 1) workers' compensation boards' and 2) physiotherapy clinics' policies on the care physiotherapists provide to workers with musculoskeletal injuries in three large Canadian provinces. Methods: The Interpretive Description framework, a qualitative methodological approach, guided this inquiry. Forty participants (30 physiotherapists and 10 leaders and administrators from physiotherapy professional groups and workers' compensation boards) were recruited in British Columbia, Ontario and Quebec to participate in an in-depth interview. Inductive analysis was conducted using constant comparative techniques. Results: Narratives from participants show that policies of workers' compensation boards and individual physiotherapy clinics have significant impacts on physiotherapists' clinical practices. Policies found at both levels often place physiotherapists in uncomfortable positions where they cannot always do what they believe to be best for their patients. Because of these policies, treatments provided to compensated injured workers markedly differ from those provided to other patients receiving physiotherapy care at the same clinic. Workers' compensation board policies such as reimbursement rates, end points for treatment and communication mechanisms, and clinic policies such as physiotherapists' remuneration schemes and restrictions on the choice of professionals had negative influences on care. Policies that were viewed as positive were board policies that recognize, promote and support physiotherapists' duties and clinics that provide organisational support for administrative tasks. Conclusion: In Canada, workers' compensation play a significant role in financing physiotherapy care for people injured at work. Despite the best intentions in promoting evidence-based guidelines and procedures regarding rehabilitation care for injured workers, complex policy factors currently limit the application of these recommendations in practice. Research that targets these policies could contribute to significant changes in clinical settings.
Mapping first‐line health care providers' roles, practices, and impacts on care for workers with compensable musculoskeletal disorders in four jurisdictions: A critical interpretive synthesis
American Journal of Industrial Medicine
BACKGROUND First-line health care providers are the primary access point for workers' benefit... more BACKGROUND First-line health care providers are the primary access point for workers' benefits. However, little is known about their impact on quality of care and return-to-work. Our objective was to critically compare literature on the practices of first-line providers for workers with musculoskeletal injuries in Ontario and Quebec (Canada), Washington State (United States), and Victoria (Australia). METHODS A critical interpretive synthesis of peer-reviewed scientific literature was conducted. The search across six databases yielded 59 relevant publications that were critically appraised. RESULTS Three themes emerged: 1) how policies about first-line health care providers' modulate worker access to care, 2) how these providers' roles, practices, and training shape disability management, and 3) how the quality of care and disability outcomes are evaluated. CONCLUSIONS First-line health care providers have a critical influence on workers' trajectories of care. A focus on their role while taking the complexity of the context into account will help orient future policy changes.
BMC Medical Education
Background: As social change agents (SCAs), occupational therapists (OTs) are expected to defend ... more Background: As social change agents (SCAs), occupational therapists (OTs) are expected to defend the rights of their clients, advocate for and with them, and try to influence organizational and political decision-makers. However, OTs do not generally feel equipped to take effective action. The overall goal of this research partnership is to support practising OTs in acquiring the knowledge and skills required to act as SCAs through a specific SCA training program and a toolkit that summarizes the key training points. Methods: The study will include three iterative phases (conceptualization, implementation and evaluation) and use a participatory process. The design of the training program and toolkit will draw on the expertise of the researchers (theoretical knowledge), a professional provincial partner and study participants (experiential knowledge). To evaluate the training program and toolkit, a self-administered evaluation questionnaire, facilitator observation grid and semi-structured guide designed to facilitate focus group discussions will be used. The quantitative and qualitative data will be analyzed using descriptive statistics and thematic analysis, respectively. The results of the initial implementation and evaluation phases will inform improvement of the training program and toolkit before starting the cycle with the following groups. Discussion: In addition to training about 100 OTs, this study will produce three main benefits: 1) development of two products, namely the SCA training program and toolkit, that are easy to reuse and potentially transferable to other professionals; 2) ownership of these products by the partner through its close involvement in all stages of the study; and 3) development of a sustainable partnership between a team of researchers and a recognized organization with networks across Canada and internationally. These three spin-offs will provide a solid basis for an increasing number of permanent implementation initiatives, in Québec and elsewhere in Canada, not just in occupational therapy but also in other professions.
Canadian Journal of Bioethics
This document is protected by copyright law. Use of the services of Érudit (including reproductio... more This document is protected by copyright law. Use of the services of Érudit (including reproduction) is subject to its terms and conditions, which can be viewed online.
Canadian Journal of Bioethics
Background: Autonomy is a central concept in both bioethics and rehabilitation. Bioethics has emp... more Background: Autonomy is a central concept in both bioethics and rehabilitation. Bioethics has emphasized autonomy as self-governance and its application in treatment decision-making. In addition to discussing decisional autonomy, rehabilitation also focuses on autonomy as functional independence. In practice, responding to patients with diminished autonomy is an important component of rehabilitation care, but also gives rise to tensions and challenges. Our objective was to better understand the complex and distinctive ways that autonomy is understood and upheld in the context of rehabilitation care by reviewing how autonomy is discussed in the rehabilitation literature. Methods: We conducted a scoping review addressing issues of autonomy in the context of mental and physical rehabilitation. Our process followed three sequential steps. We extracted and analyzed bibliometric information. We then examined how autonomy was defined and conceptualized. Finally, we examined how the article...
Healthcare Policy, 2015
Musculoskeletal disorders are among the leading causes of work-related physical disability in the... more Musculoskeletal disorders are among the leading causes of work-related physical disability in the province of Quebec in Canada. The authors conducted a focus group study with physiotherapists and physical rehabilitation therapists working with patients whose treatments are compensated by the Quebec Workers' Compensation Board with the goal of exploring quality of care and ethical issues. Three main themes were identified: (1) systemic factors, (2) complexity in treatment decisions and (3) inequality of care. Although physiotherapy professionals strive to give these patients the best possible care, patients might not always be provided with optimal or equal treatment. When compared with other patients, there appear to be differences with respect to access to care and types of services offered to injured workers, raising equity concerns. Factors that shape and constrain quality of physiotherapy services for injured workers need to be addressed to improve care for these patients.
A four-jurisdiction qualitative analysis of workers’ compensation healthcare policies
Safety and Health at Work
Additional file 2: of Physiotherapy for injured workers in Canada: are insurers' and clinics' policies threatening good quality and equity of care? Results of a qualitative study
Summary of key questions asked to leaders and administrators participating in the study. (DOCX 14... more Summary of key questions asked to leaders and administrators participating in the study. (DOCX 147 kb)
Additional file 1: of Physiotherapy for injured workers in Canada: are insurers' and clinics' policies threatening good quality and equity of care? Results of a qualitative study
Summary of key questions asked to clinicians participating in the study. (DOCX 129 kb)
There is growing recognition of the importance of knowledge translation activities in physical th... more There is growing recognition of the importance of knowledge translation activities in physical therapy to ensure that research findings are integrated into clinical practice, and increasing numbers of knowledge translation interventions are being conducted. Although various frameworks have been developed to guide and facilitate the process of translating knowledge into practice, these tools have been infrequently used in physical therapy knowledge translation studies to date. Knowledge translation in physical therapy implicates multiple stakeholders and environments and involves numerous steps. In light of this complexity, the use of explicit conceptual frame-works by clinicians and researchers conducting knowledge translation interventions is associated with a range of potential benefits. This perspective article argues that such frameworks are important resources to promote the uptake of new evidence in physical therapist practice settings. Four key benefits associated with the us...
1 Running head: Contribution of Conceptual Frameworks Knowledge Translation and Implementation Research The Contribution of Conceptual Frameworks to Knowledge Translation Interventions in Physical Therapy
and CJM-IU-UQÀM Chair on knowledge translation in the field of child and family welfare.
Les physiothérapeutes cliniciens-chercheurs : un rôle de pratique avancée trop peu soutenu pour les physiothérapeutes au Canada
Physiotherapy Canada
Physiotherapists as Clinician-Scientists: An Insufficiently Supported Advanced-Practice Physiotherapy Role in Canada
Physiotherapy Canada. Physiotherapie Canada, 2021
What is pain-related suffering? Conceptual critiques, key attributes, and outstanding questions
The Journal of Pain
Les physiothérapeutes cliniciens-chercheurs : un rôle de pratique avancée trop peu soutenu pour les physiothérapeutes au Canada
Physiotherapy Canada. Physiotherapie Canada, 2021
BMC Musculoskeletal Disorders
Background Optimizing patients’ total hip and knee arthroplasty (THA/TKA) experience is as crucia... more Background Optimizing patients’ total hip and knee arthroplasty (THA/TKA) experience is as crucial for providing high quality care as improving safety and clinical effectiveness. Yet, little evidence is available on patient experience in standard-inpatient and enhanced recovery after surgery (ERAS)-outpatient programs. Therefore, this study aimed to gain a more in-depth understanding of the patient experience of ERAS-outpatient programs in comparison to standard-inpatient programs. Methods We conducted a convergent mixed methods study of 48 consecutive patients who experienced both standard-inpatient and ERAS-outpatient THA/TKA contralaterally. A reflective thematic analysis was conducted based on data collected via a questionnaire. Bivariate correlations between the patient experience and patients’ characteristics, clinical outcomes and care components satisfaction were performed. Then, the quantitative and qualitative data were integrated together. Results The theme Support makes ...
Thèse présentée à la Faculté des études supérieures en vue de l'obtention du grade de Philosophia... more Thèse présentée à la Faculté des études supérieures en vue de l'obtention du grade de Philosophiae Doctor (Ph.D.) en Sciences de la réadaptation Mai 2017
Development of a national pain management competency profile to guide entry-level physiotherapy education in Canada
Canadian Journal of Pain
Canadian Journal of Occupational Therapy
Background. Change agents’ actions have been studied mainly from a theoretical perspective. Purpo... more Background. Change agents’ actions have been studied mainly from a theoretical perspective. Purpose. This study aimed to empirically identify occupational therapists’ actual change agent actions. Method. As part of a research partnership with the Canadian Association of Occupational Therapists-Québec chapter, we conducted this cross-sectional pilot study using an online survey. Findings. The change agent practices of our 103 participants involve many types of actions but show underinvestment in mass communication. Mass communication actions are more frequent when participants have greater experience, additional academic degrees, and training in change agency. Also, occupational therapists with additional academic degrees and change agency training tend to use a wider variety of actions. Finally, our participants’ actions principally target actors in the clinical context, rarely political actors. Implications. Our results suggest that occupational therapists can and will invest in th...
Tensions Living Out Professional Values for Physical Therapists Treating Injured Workers
Qualitative Health Research
Health care services provided by workers’ compensation systems aim to facilitate recovery for inj... more Health care services provided by workers’ compensation systems aim to facilitate recovery for injured workers. However, some features of these systems pose barriers to high quality care and challenge health care professionals in their everyday work. We used interpretive description methodology to explore ethical tensions experienced by physical therapists caring for patients with musculoskeletal injuries compensated by Workers’ Compensation Boards. We conducted in-depth interviews with 40 physical therapists and leaders in the physical therapy and workers’ compensation fields from three Canadian provinces and analyzed transcripts using concurrent and constant comparative techniques. Through our analysis, we developed inductive themes reflecting significant challenges experienced by participants in upholding three core professional values: equity, competence, and autonomy. These challenges illustrate multiple facets of physical therapists’ struggles to uphold moral commitments and pr...
BMC Health Services Research
Background: In recent years, significant efforts have been made to improve the provision of care ... more Background: In recent years, significant efforts have been made to improve the provision of care for compensated injured workers internationally. However, despite increasing efforts at implementing best practices in this field, some studies show that policies overseeing the organisation of care for injured workers can have perverse influences on healthcare providers' practices and can prevent workers from receiving the best care possible. The influence of these policies on physiotherapists' practices has yet to be investigated. Our objectives were thus to explore the influence of 1) workers' compensation boards' and 2) physiotherapy clinics' policies on the care physiotherapists provide to workers with musculoskeletal injuries in three large Canadian provinces. Methods: The Interpretive Description framework, a qualitative methodological approach, guided this inquiry. Forty participants (30 physiotherapists and 10 leaders and administrators from physiotherapy professional groups and workers' compensation boards) were recruited in British Columbia, Ontario and Quebec to participate in an in-depth interview. Inductive analysis was conducted using constant comparative techniques. Results: Narratives from participants show that policies of workers' compensation boards and individual physiotherapy clinics have significant impacts on physiotherapists' clinical practices. Policies found at both levels often place physiotherapists in uncomfortable positions where they cannot always do what they believe to be best for their patients. Because of these policies, treatments provided to compensated injured workers markedly differ from those provided to other patients receiving physiotherapy care at the same clinic. Workers' compensation board policies such as reimbursement rates, end points for treatment and communication mechanisms, and clinic policies such as physiotherapists' remuneration schemes and restrictions on the choice of professionals had negative influences on care. Policies that were viewed as positive were board policies that recognize, promote and support physiotherapists' duties and clinics that provide organisational support for administrative tasks. Conclusion: In Canada, workers' compensation play a significant role in financing physiotherapy care for people injured at work. Despite the best intentions in promoting evidence-based guidelines and procedures regarding rehabilitation care for injured workers, complex policy factors currently limit the application of these recommendations in practice. Research that targets these policies could contribute to significant changes in clinical settings.
Mapping first‐line health care providers' roles, practices, and impacts on care for workers with compensable musculoskeletal disorders in four jurisdictions: A critical interpretive synthesis
American Journal of Industrial Medicine
BACKGROUND First-line health care providers are the primary access point for workers' benefit... more BACKGROUND First-line health care providers are the primary access point for workers' benefits. However, little is known about their impact on quality of care and return-to-work. Our objective was to critically compare literature on the practices of first-line providers for workers with musculoskeletal injuries in Ontario and Quebec (Canada), Washington State (United States), and Victoria (Australia). METHODS A critical interpretive synthesis of peer-reviewed scientific literature was conducted. The search across six databases yielded 59 relevant publications that were critically appraised. RESULTS Three themes emerged: 1) how policies about first-line health care providers' modulate worker access to care, 2) how these providers' roles, practices, and training shape disability management, and 3) how the quality of care and disability outcomes are evaluated. CONCLUSIONS First-line health care providers have a critical influence on workers' trajectories of care. A focus on their role while taking the complexity of the context into account will help orient future policy changes.
BMC Medical Education
Background: As social change agents (SCAs), occupational therapists (OTs) are expected to defend ... more Background: As social change agents (SCAs), occupational therapists (OTs) are expected to defend the rights of their clients, advocate for and with them, and try to influence organizational and political decision-makers. However, OTs do not generally feel equipped to take effective action. The overall goal of this research partnership is to support practising OTs in acquiring the knowledge and skills required to act as SCAs through a specific SCA training program and a toolkit that summarizes the key training points. Methods: The study will include three iterative phases (conceptualization, implementation and evaluation) and use a participatory process. The design of the training program and toolkit will draw on the expertise of the researchers (theoretical knowledge), a professional provincial partner and study participants (experiential knowledge). To evaluate the training program and toolkit, a self-administered evaluation questionnaire, facilitator observation grid and semi-structured guide designed to facilitate focus group discussions will be used. The quantitative and qualitative data will be analyzed using descriptive statistics and thematic analysis, respectively. The results of the initial implementation and evaluation phases will inform improvement of the training program and toolkit before starting the cycle with the following groups. Discussion: In addition to training about 100 OTs, this study will produce three main benefits: 1) development of two products, namely the SCA training program and toolkit, that are easy to reuse and potentially transferable to other professionals; 2) ownership of these products by the partner through its close involvement in all stages of the study; and 3) development of a sustainable partnership between a team of researchers and a recognized organization with networks across Canada and internationally. These three spin-offs will provide a solid basis for an increasing number of permanent implementation initiatives, in Québec and elsewhere in Canada, not just in occupational therapy but also in other professions.
Canadian Journal of Bioethics
This document is protected by copyright law. Use of the services of Érudit (including reproductio... more This document is protected by copyright law. Use of the services of Érudit (including reproduction) is subject to its terms and conditions, which can be viewed online.
Canadian Journal of Bioethics
Background: Autonomy is a central concept in both bioethics and rehabilitation. Bioethics has emp... more Background: Autonomy is a central concept in both bioethics and rehabilitation. Bioethics has emphasized autonomy as self-governance and its application in treatment decision-making. In addition to discussing decisional autonomy, rehabilitation also focuses on autonomy as functional independence. In practice, responding to patients with diminished autonomy is an important component of rehabilitation care, but also gives rise to tensions and challenges. Our objective was to better understand the complex and distinctive ways that autonomy is understood and upheld in the context of rehabilitation care by reviewing how autonomy is discussed in the rehabilitation literature. Methods: We conducted a scoping review addressing issues of autonomy in the context of mental and physical rehabilitation. Our process followed three sequential steps. We extracted and analyzed bibliometric information. We then examined how autonomy was defined and conceptualized. Finally, we examined how the article...
Critical Physiotherapy Network, 2018
Submitted and reviewed blog post about monolingualism at the World Confederation for Physical The... more Submitted and reviewed blog post about monolingualism at the World Confederation for Physical Therapy congress. The post was published on 5 February 2018, available at: https://criticalphysio.net/2018/02/05/the-costs-of-translation/
Canadian Journal of Bioethics, 2018
We present an overview of our workshop about equity and physiotherapy, held at the Canadian Physi... more We present an overview of our workshop about equity and physiotherapy, held at the Canadian Physiotherapy Congress (Montréal18), bringing this conversation outside the borders of the physiotherapy profession.