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澳大利亚和新西兰临床医生对单纯冠状动脉旁路移植(CABG)术后患者的物理治疗活动和行走管理的观点调查

Physiotherapy mobility and walking management of uncomplicated coronary artery bypass graft (CABG) surgery patients: a survey of clinicians' perspectives in Australia and New Zealand.

机构信息

Physiotherapy Department, Liverpool Hospital, Sydney, NSW, Australia.

Discipline of Physiotherapy, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia.

出版信息

Physiother Theory Pract. 2020 Jan;36(1):226-240. doi: 10.1080/09593985.2018.1482582. Epub 2018 Jun 13.

Abstract

This study aimed to determine current mobility and walking management by physiotherapists of patients undergoing coronary artery bypass graft (CABG) surgery, the clinical milestones expected and physiotherapists' perception of the severity of pain experienced by patients after surgery. Cross sectional study using a questionnaire. All hospitals in Australia and New Zealand that perform cardiac surgery ( = 54) were invited to complete a questionnaire. Forty-one questionnaires were returned and analysed (response rate 76%). Walking distance was a clinical milestone after CABG surgery. Walking and transferring patients from bed to chair required the most time of physiotherapists during one treatment session. Physiotherapists perceived that patients experienced most pain on day one after surgery [mean (SD)] visual analogue scale (VAS) 41 (16) mm and this reduced by day four to VAS 15 (10) mm. Patients' pain was perceived to be significantly higher after physiotherapy sessions compared with before ( < 0.01). Thirty-seven respondents (90%) believed that patients' pain was well managed for physiotherapy treatments. A majority of the respondents (68%) believed that pain was not a limiting factor in the distance patients walked in a physiotherapy session and most (90%) believed that general fatigue limited walk distance. This research provides current mobility and walking management by physiotherapists of patients undergoing CABG surgery in Australia and New Zealand.

摘要

本研究旨在确定接受冠状动脉旁路移植术(CABG)的患者的物理治疗师目前的活动能力和行走管理情况、预计的临床里程碑以及物理治疗师对术后患者疼痛严重程度的感知。采用问卷调查的横断面研究。邀请澳大利亚和新西兰所有进行心脏手术的医院(=54 家)完成问卷。共收回并分析了 41 份问卷(应答率 76%)。CABG 手术后的行走距离是一个临床里程碑。行走和将患者从床上转移到椅子上是物理治疗师在一次治疗中花费时间最多的项目。物理治疗师认为患者在术后第一天疼痛最严重[平均(SD)]视觉模拟量表(VAS)为 41(16)mm,第四天降至 VAS 15(10)mm。与治疗前相比,患者在治疗后感到的疼痛明显更高(<0.01)。37 名(90%)受访者认为,患者的疼痛在接受物理治疗时得到了很好的控制。大多数受访者(68%)认为疼痛不是物理治疗中患者行走距离的限制因素,大多数(90%)认为一般疲劳限制了行走距离。本研究提供了澳大利亚和新西兰接受 CABG 手术的患者的当前活动能力和行走管理情况。

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