Peter W F, van der Wees P J, Hendriks E J M, de Bie R A, Verhoef J, de Jong Z, van Bodegom-Vos L, Hilberdink W K H A, Vliet Vlieland T P M
Department of Orthopaedics, Leiden University Medical Centre (LUMC), Leiden, the Netherlands; Reade, Centre of Rehabilitation and Rheumatology (formerly Jan van Breemen Institute), Amsterdam, the Netherlands.
Musculoskeletal Care. 2013 Dec;11(4):193-202. doi: 10.1002/msc.1041. Epub 2012 Dec 21.
The aim of the present study was to develop process quality indicators for physiotherapy care based on key recommendations of the Dutch physiotherapy guideline on hip and knee osteoarthritis (OA).
Guideline recommendations were rated for their relevance by an expert panel, transformed into potential indicators and incorporated into a questionnaire, the Quality Indicators for Physiotherapy in Hip and Knee Osteoarthritis (QIP-HKOA). Adherence with each indicator was rated on a Likert scale (0 = never to 4 = always). The QIP-HKOA was administered to groups of expert (n = 51) and general (n = 134) physiotherapists (PTs) to test its discriminative power. Reliability was tested in a subgroup of 118 PTs by computing the intraclass correlation coefficient (ICC). QIP-HKOA items were included if they were considered to be related to the cornerstones of physiotherapy in hip and knee OA (exercises and education), had discriminative power and/or if they were followed by <75% of PTs in both groups.
Nineteen indicators were derived from 41 recommendations. Twelve indicators were considered to be the cornerstones of physiotherapy care; six indicators had discriminative power and/or were followed by <75% PTs in both groups, resulting in an 18-item QIP- HKOA. The QIP-HKOA score was significantly higher with expert [60.73; standard deviation (SD) 5.67] than with general PTs (54.65; SD 6.17) (p < 0.001). The ICC of the QIP-HKOA among 46/118 PTs was 0.89.
The QIP-HKOA, based on 18 process indicators derived from a physiotherapy guideline on hip and knee OA was found to be reliable and discriminated between expert and general PTs. Its ability to measure improvement in the quality of the process of physiotherapy care needs to be further examined.
本研究旨在根据荷兰髋膝关节骨关节炎（OA）物理治疗指南的关键建议，制定物理治疗护理的过程质量指标。
由一个专家小组对指南建议的相关性进行评级，将其转化为潜在指标并纳入一份问卷，即髋膝关节骨关节炎物理治疗质量指标（QIP-HKOA）。每个指标的依从性采用李克特量表进行评分（0=从不，4=总是）。将QIP-HKOA应用于专家物理治疗师组（n=51）和普通物理治疗师组（n=134），以测试其区分能力。通过计算组内相关系数（ICC），在118名物理治疗师的一个亚组中测试可靠性。如果QIP-HKOA项目被认为与髋膝关节OA物理治疗的基石（运动和教育）相关、具有区分能力和/或两组中<75%的物理治疗师遵循这些项目，则将其纳入。
从41条建议中得出了19项指标。12项指标被认为是物理治疗护理的基石；6项指标具有区分能力和/或两组中<75%的物理治疗师遵循这些指标，从而产生了一个包含18个条目的QIP-HKOA。专家物理治疗师的QIP-HKOA评分[60.73；标准差（SD）5.67]显著高于普通物理治疗师（54.65；SD 6.17）（p<0.001）。46/118名物理治疗师中QIP-HKOA的ICC为0.89。
基于从髋膝关节OA物理治疗指南得出的18项过程指标的QIP-HKOA被发现是可靠的，并且能够区分专家物理治疗师和普通物理治疗师。其测量物理治疗护理过程质量改善的能力需要进一步研究。
