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Table 1 The constructs and components of the NPT in relation to the use of the FMA-UE

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

Construct

Component

Description

Coherence

 

Process of understanding the purpose and benefits of using the FMA-UE

 

Differentiation

Actions OTs take to understand how using the FMA-UE differs from other outcome measures used in clinical practice

 

Communal specification

Actions OTs do collectively (e.g. a group or a team) to understand the aims, objectives, and benefits of implementing and/or using the FMA-UE

 

Individual specification

Actions individual OTs take to understand the efforts needed to implement and use the FMA-UE

 

Internalisation

The work OTs do to understand the value, benefits, and importance of using the FMA-UE in their practice

Cognitive participation

 

The relational work to define and organise the efforts needed to build the routine practice of using the FMA-UE

 

Initiation

Actions taken at the individual and/or group level to initiate and drive the use of the FMA-UE among OTs

 

Enrolment

The work of engaging OTs to support the routine use of the FMA-UE

 

Legitimation

The work that OTs do (at individual and/or group level) to justify their involvement in the routine practice of using the FMA-UE

 

Activation

The continuing work to sustain the routine practice of using the FMA-UE

Collective action

 

The operational work needed to enact the routine practice of using the FMA-UE

 

Interactional workability

The interactional work to operationalise the routine practice of using the FMA-UE

 

Relational integration

The knowledge work to build OTs’ confidence in administering the FMA-UE and to instil responsibility to use the FMA-UE in their routine clinical practice

 

Skill set workability

The work of dividing and allocating tasks and resources according to one’s competency in using the FMA-UE

 

Contextual integration

The work of integrating the use of the FMA-UE into existing work processes and contexts. It includes allocation of resources or endorsing procedures to support the use of the FMA-UE

Reflexive monitoring

 

The work of appraising and evaluating the effectiveness of routinely using the FMA-UE

 

Systemisation

The work of collecting and analysing data to determine the usefulness of the FMA-UE and the adherence to routine use of the FMA-UE among OTs

 

Communal appraisal

Actions taken at a group level to evaluate the value (usefulness, worth) of the FMA-UE and adherence to routine use of the measure

 

Individual appraisal

The work by individual OTs to evaluate the value (usefulness, worth) of using the FMA-UE on their clinical practice and patients

 

Reconfiguration

Actions taken after evaluating and appraising the effectiveness of routinely using the FMA-UE

  1. FMA-UE Fugl-Meyer Assessment of the Upper Extremity, OTs Occupational therapists