Dewhirst Regan C, Ellis Daniel P, Mandara Emily A, Jette Diane U
R.C. Dewhirst, PT, DPT, VASTA Physical Therapy, South Burlington, Vermont.
D.P. Ellis, PT, DPT, Oregon Neurosport Physical Therapy, Junction City, Oregon.
Phys Ther. 2016 Jul;96(7):1085-92. doi: 10.2522/ptj.20150009. Epub 2016 Feb 18.
Activity Measure for Post-Acute Care (AM-PAC) "6-Clicks" tools are functional measures used in acute care. No studies have identified reactions and perceptions of therapists in implementing these measures.
The purpose of this study was to explore therapists' perceptions regarding the application and implementation of AM-PAC "6-Clicks" tools.
This study used a qualitative design with thematic analysis.
A convenience sample of 13 physical therapists and occupational therapists participated in semistructured telephone interviews. Interviews were recorded, transcribed, and coded, after which thematic analysis was used to determine common themes.
Five themes were identified: (1) unclear purpose, (2) lack of confidence in scoring, (3) too simple for decision making or generalizing patient function, (4) no effect on clinical routine, and (5) potential for communicating patient function across disciplines.
Participants came from one health care system. A relatively small percentage of staff agreed to participate in this study, and additional interviews might have revealed new themes.
As participants in this study implemented the AM-PAC "6-Clicks" tools, they considered the role of the measures, how they fit within the context of practice, and their value. They also were concerned with the accuracy and feasibility of the tools. The tools were accepted as potentially valuable to assist administrative decisions and research; however, they were not perceived as particularly useful for routine patient care. Participants lacked complete confidence in the reliability of their scoring and expressed concern that the scores might be substituted for their clinical decision making. They also felt that the tools were too simple to fully reflect patients' overall function and were not useful alone for discharge planning. Participants believed the tools had the potential to be used for communication among colleagues about patients' physical function.
急性后期护理活动测量（AM-PAC）“6 点击”工具是用于急性护理的功能测量工具。尚无研究确定治疗师在实施这些测量工具时的反应和看法。
本研究的目的是探讨治疗师对 AM-PAC“6 点击”工具应用和实施的看法。
本研究采用定性设计和主题分析。
13 名物理治疗师和职业治疗师的便利样本参与了半结构化电话访谈。访谈进行了录音、转录和编码，之后使用主题分析来确定共同主题。
确定了五个主题：（1）目的不明确，（2）对评分缺乏信心，（3）对决策或概括患者功能过于简单，（4）对临床常规无影响，（5）跨学科沟通患者功能的潜力。
参与者来自一个医疗保健系统。同意参与本研究的工作人员比例相对较小，更多访谈可能会揭示新的主题。
在本研究中，参与者在实施 AM-PAC“6 点击”工具时，考虑了这些测量工具的作用、它们在实践背景中的契合度及其价值。他们还关注这些工具的准确性和可行性。这些工具被认为对协助行政决策和研究可能有价值；然而，它们被认为对常规患者护理并非特别有用。参与者对其评分的可靠性缺乏完全信心，并担心评分可能会取代他们的临床决策。他们还认为这些工具过于简单，无法充分反映患者的整体功能，单独用于出院计划也没有用处。参与者认为这些工具有可能用于同事之间关于患者身体功能的沟通。
