Parr Sarah, May Stephen
Department of Orthopaedics, Watford General Hospital, Vicarage Road, Watford WD18 0HB, UK.
Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield S10 2BP, UK.
Physiotherapy. 2014 Sep;100(3):235-41. doi: 10.1016/j.physio.2013.09.004. Epub 2013 Oct 4.
Evidence-based practice has become fundamentally important in the field of musculoskeletal physiotherapy, which include clinical practice guidelines, such as those developed by National Institute for Health and Clinical Excellence (NICE) for low back pain.
To gauge whether musculoskeletal physiotherapist working in the UK are compliant with the NICE guidelines for back pain, and if they believe them to be practical and relevant to their current practice.
Descriptive cross-sectional voluntary electronic survey.
A survey of musculoskeletal physiotherapists currently working in the UK was conducted through an anonymous online data collection website over a two month data collection period. Data was collected about demographic details of participants, and their views about the NICE guidelines through a specially designed questionnaire, and are presented descriptively.
Two hundred and twenty-three therapists participated. Following a thematic content analysis seven key themes were identified about the guidelines: they facilitated evidence-based practice; they were unrealistic and idealistic; they did not facilitate a multimodal approach; they promoted largely a passive approach; they challenged therapist autonomy; they were outdated; they lacked relevance and specificity.
Musculoskeletal physiotherapists strongly believe in the principles of EBP, and thought the NICE back pain guidelines were relevant to their practice. However the recommendations made within the guidelines were not realistic in day to day practice and they impacted negatively on the practice in a number of ways.
循证实践在肌肉骨骼物理治疗领域已变得至关重要,其中包括临床实践指南,如英国国家卫生与临床优化研究所(NICE)制定的腰痛指南。
评估在英国工作的肌肉骨骼物理治疗师是否遵循NICE腰痛指南,以及他们是否认为这些指南切实可行且与当前实践相关。
描述性横断面自愿电子调查。
通过一个匿名在线数据收集网站,在为期两个月的数据收集期内对目前在英国工作的肌肉骨骼物理治疗师进行调查。通过一份专门设计的问卷收集参与者的人口统计学细节以及他们对NICE指南的看法,并进行描述性呈现。
223名治疗师参与了调查。经过主题内容分析,确定了关于这些指南的七个关键主题:它们促进了循证实践;它们不切实际且理想化;它们没有促进多模式方法;它们主要提倡被动方法;它们挑战了治疗师的自主性;它们过时了;它们缺乏相关性和特异性。
肌肉骨骼物理治疗师坚信循证实践原则,并认为NICE腰痛指南与他们的实践相关。然而,指南中的建议在日常实践中并不现实,并且在许多方面对实践产生了负面影响。