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将常见肌肉骨骼疾病相关知识转化为物理治疗实践的策略:系统评价。

Strategies to translate knowledge related to common musculoskeletal conditions into physiotherapy practice: a systematic review.

机构信息

School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada.

School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada.

出版信息

Physiotherapy. 2018 Mar;104(1):1-8. doi: 10.1016/j.physio.2017.05.002. Epub 2017 May 26.

Abstract

BACKGROUND

Many physiotherapists underuse evidence-based practice guidelines or recommendations when treating patients with musculoskeletal disorders, yet synthesis of knowledge translation interventions used within the field of physiotherapy fails to offer clear conclusions to guide the implementation of clinical practice guidelines.

OBJECTIVES

To evaluate the effectiveness of various knowledge translation interventions used to implement changes in the practice of current physiotherapists treating common musculoskeletal issues.

DATA SOURCES

A computerized literature search of MEDLINE, CINHAL and ProQuest of systematic reviews (from inception until May 2016) and primary research studies (from January 2010 until June 2016).

STUDY SELECTION AND ELIGIBILITY CRITERIA

Eligibility criteria specified articles evaluating interventions for translating knowledge into physiotherapy practice.

DATA EXTRACTION AND DATA SYNTHESIS

Two reviewers independently screened the titles and abstracts, reviewed full-text articles, performed data extraction, and performed quality assessment. Of a total of 13014 articles located and titles and abstracts screened, 34 studies met the inclusion criteria, including three overlapping publications, resulting in 31 individual studies.

RESULTS

Knowledge translation interventions appear to have resulted in a positive change in physiotherapist beliefs, attitudes, skills and guideline awareness. However, no consistent improvement in clinical practice, patient and economic outcomes were observed.

LIMITATIONS

The studies included had small sample sizes and low methodological quality. The heterogeneity of the studies was not conducive to pooling the data.

CONCLUSIONS AND IMPLICATION OF KEY FINDINGS

The intensity and type of knowledge translation intervention seem to have an effect on practice change. More research targeting financial, organizational and regulatory knowledge translation interventions is needed.

摘要

背景

许多物理治疗师在治疗肌肉骨骼疾病患者时未能充分利用基于证据的实践指南或建议,但该领域的知识转化干预措施的综合未能得出明确的结论来指导临床实践指南的实施。

目的

评估用于实施当前治疗常见肌肉骨骼问题的物理治疗师实践变化的各种知识转化干预措施的有效性。

资料来源

对 MEDLINE、CINHAL 和 ProQuest 中的系统评价(从开始到 2016 年 5 月)和主要研究进行计算机化文献检索。

研究选择和纳入标准

纳入标准指定评估将知识转化为物理治疗实践的干预措施的文章。

数据提取和综合

两名审查员独立筛选标题和摘要,审查全文文章,进行数据提取,并进行质量评估。在总共定位的 13014 篇文章和筛选的标题和摘要中,有 34 项研究符合纳入标准,包括三项重叠出版物,共 31 项单独研究。

结果

知识转化干预措施似乎导致治疗师的信念、态度、技能和指南意识发生了积极变化。然而,观察到临床实践、患者和经济结果没有一致改善。

局限性

纳入的研究样本量小,方法学质量低。研究的异质性不利于数据的汇总。

结论和关键发现的意义

知识转化干预的强度和类型似乎对实践变化有影响。需要更多针对财务、组织和监管知识转化干预的研究。

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