Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland Australia.
Department of Surgery, The University of Melbourne, Melbourne, Victoria Australia.
Musculoskelet Sci Pract. 2018 Dec;38:30-36. doi: 10.1016/j.msksp.2018.09.005. Epub 2018 Sep 6.
Formally trained and accredited physiotherapists delivered Stress Inoculation Training (SIT) integrated with guideline-based physiotherapy management to individuals with acute whiplash associated disorders (WAD) as part of a randomised controlled trial. The delivery of SIT by physiotherapists is new.
To investigate physiotherapists' perspectives on delivering SIT as part of the trial and in routine practice.
Qualitative descriptive.
Physiotherapists (n = 11) participated in semi-structured interviews. Interviews were audio-recorded, transcribed verbatim, and analysed thematically. Findings were triangulated against an audit of physiotherapists' adherence to the SIT protocol.
Three themes were identified: perceived value; capacity to deliver; and adaptation and implementation. Physiotherapists' saw value in SIT in that they perceived the program to have improved patient outcomes, enhanced their therapeutic alliance, and provided new skills to manage psychological contributors to WAD. Physiotherapists' capacity to deliver the program was facilitated through the development of confidence in their ability to deliver sessions, viewing SIT as falling within their current professional identity, and having confidence in their ability to manage mismatches in patients' expectations of care. All physiotherapists reported having used SIT to some extent in routine practice, by selectively delivering sessions and/or integrating the content with other management. Physiotherapists were able to deliver SIT as was intended (94.6% adherence).
Physiotherapists' supported adding SIT to usual management of individuals with acute WAD. Education on SIT principles is recommended during pre-professional training to facilitate future implementation.
在一项随机对照试验中，经过正规培训和认证的物理治疗师将应激接种训练（SIT）与基于指南的物理治疗管理相结合，为急性颈扭伤相关疾病（WAD）患者提供服务。SIT 由物理治疗师提供，这是一种新的治疗方法。
调查物理治疗师在试验和常规实践中提供 SIT 的看法。
定性描述。
11 名物理治疗师参与了半结构化访谈。访谈进行了录音，并逐字转录，然后进行主题分析。研究结果与物理治疗师对 SIT 协议的遵守情况进行了审计。
确定了三个主题：感知价值；提供能力；适应和实施。物理治疗师认为 SIT 具有价值，因为他们认为该方案改善了患者的治疗效果，增强了他们的治疗联盟，并提供了管理 WAD 心理因素的新技能。物理治疗师提供该方案的能力通过以下方式得到促进：对他们提供课程的能力建立信心，将 SIT 视为符合他们当前的专业身份，并对管理患者对护理的期望不匹配的能力有信心。所有物理治疗师都报告说，他们在常规实践中已经在一定程度上使用了 SIT，通过选择性地提供课程和/或将其内容与其他管理方法相结合。物理治疗师能够按照预期的方式提供 SIT（遵守率为 94.6%）。
物理治疗师支持将 SIT 添加到急性 WAD 患者的常规治疗中。建议在专业培训前提供关于 SIT 原则的教育，以促进未来的实施。
