World Confederation for Physical Therapy, Victoria Charity Centre, 11 Belgrave Rd, London, SW1V 1RB, UK.
Phys Ther. 2013 Apr;93(4):449-59. doi: 10.2522/ptj.20120060. Epub 2012 Nov 29.
International policy advocates for direct access, but the extent to which it exists worldwide was unknown.
The purpose of this study was to map the presence of direct access to physical therapy services in the member organizations of the World Confederation for Physical Therapy (WCPT) in the context of physical therapist practice and health systems.
A 2-stage, mixed-method, descriptive study was conducted.
A purposive sample of member organizations of WCPT in Europe was used to refine the survey instrument, followed by an online survey sent to all WCPT member organizations. Data were analyzed using descriptive statistics, and content analysis was used to analyze open-ended responses to identify themes.
A response rate of 68% (72/106) was achieved. Direct access to physical therapy was reported by 58% of the respondents, with greater prevalence in private settings. Organizations reported that professional (entry-level) education equipped physical therapists for direct access in 69% of the countries. National physical therapy associations (89%) and the public (84%) were thought to be in support of direct access, with less support perceived from policy makers (35%) and physicians (16%). Physical therapists' ability to assess, diagnose, and refer patients on to specialists was more prevalent in the presence of direct access.
The findings may not be representative of the Asia Western Pacific (AWP) region, where there was a lower response rate.
Professional legislation, the medical profession, politicians, and policy makers are perceived to act as both barriers to and facilitators of direct access. Evidence for clinical effectiveness and cost-effectiveness and examples of good practice are seen as vital resources that could be shared internationally, and professional leadership has an important role to play in facilitating change and advocacy.
国际政策提倡直接访问，但全球范围内直接访问的程度尚不清楚。
本研究旨在描绘世界物理治疗联盟（WCPT）成员组织中物理治疗师实践和卫生系统中直接获得物理治疗服务的情况。
采用两阶段、混合方法、描述性研究。
使用 WCPT 欧洲成员组织的目的抽样来完善调查工具，然后向所有 WCPT 成员组织发送在线调查。使用描述性统计分析数据，并使用内容分析对开放式回答进行分析，以确定主题。
实现了 68%（72/106）的回复率。58%的受访者报告了直接访问，在私人环境中更为普遍。组织报告称，专业（入门级）教育使物理治疗师在 69%的国家具备直接访问的能力。国家物理治疗协会（89%）和公众（84%）被认为支持直接访问，而政策制定者（35%）和医生（16%）的支持较少。在存在直接访问的情况下，物理治疗师评估、诊断和将患者转介给专家的能力更为普遍。
调查结果可能无法代表亚洲-西太平洋（AWP）地区，该地区的回复率较低。
专业立法、医疗行业、政治家和政策制定者被认为既是直接访问的障碍，也是其促进因素。临床有效性和成本效益的证据以及良好实践的例子被视为可以在国际上共享的重要资源，专业领导在促进变革和倡导方面发挥着重要作用。
