澳大利亚肌肉骨骼物理治疗师对手动治疗前颈椎预手法筛查的看法、态度和意见:来自焦点小组的报告。
Australian musculoskeletal physiotherapist's perceptions, attitudes and opinions towards pre-manipulative screening of the cervical spine prior to manual therapy: Report from the focus groups.
机构信息
School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, Queensland, Australia.
Four degrees: Qualitative Research and Professional Development Consultancy, Brisbane, Queensland, Australia.
出版信息
Musculoskelet Sci Pract. 2019 Feb;39:123-129. doi: 10.1016/j.msksp.2018.12.005. Epub 2018 Dec 12.
BACKGROUND
The Australian Physiotherapy Association 2006 VBI Guidelines are used by many of the member organisations of IFOMPT. These Guidelines are due for revision incorporating recent research findings, international guides, and member's recommendations.
PURPOSE
To identify and consider Australian musculoskeletal physiotherapists' recommendations to inform revision of the 2006 VBI Guidelines.
METHODS
Focus groups were conducted in the five larger Australian state capitals by an independent qualitative researcher and a subject expert. Qualitative data were collected from 41 musculoskeletal physiotherapists who were purposefully recruited for their broad range of experience and qualifications. The five stage Framework Analysis approach was used to analyse and interpret data.
RESULTS
Participants recommended that the revised Guidelines have a new title reflecting a broader risk assessment and management approach, encompassing both musculoskeletal and relevant cardio-vascular risks and informed by contemporary research evidence and clinical experience. Participants requested a positively worded stepwise guide to clinical reasoning for all cervical spine manual treatment scenarios including the process of gaining and recording consent. Participants advised on individual components of the Guidelines needing to be revised or removed. The revised Guidelines, once approved, need to be disseminated in written and electronic formats to all clinicians. Training and education are required to ensure appropriate uptake within and beyond the profession.
CONCLUSIONS AND IMPLICATIONS
To ensure their clinical acceptance and utility, the Revised Guidelines need to reflect the current use and recommendations of musculoskeletal physiotherapists. Sound knowledge translation processes are then needed to ensure that the Guidelines are incorporated into practice.
背景
澳大利亚物理治疗协会 2006 年 VBI 指南被 IFOMPT 的许多成员组织使用。这些指南即将修订,纳入最近的研究结果、国际指南和成员的建议。
目的
确定并考虑澳大利亚肌肉骨骼物理治疗师的建议,为 2006 年 VBI 指南的修订提供信息。
方法
由一名独立的定性研究人员和一名学科专家在五个较大的澳大利亚州首府进行焦点小组讨论。从 41 名肌肉骨骼物理治疗师那里收集了定性数据,这些治疗师是根据其广泛的经验和资格有针对性地招募的。采用五阶段框架分析方法对数据进行分析和解释。
结果
参与者建议修订后的指南有一个新的标题,反映更广泛的风险评估和管理方法,包括肌肉骨骼和相关心血管风险,并以当代研究证据和临床经验为依据。参与者要求为所有颈椎手动治疗场景制定一个措辞积极的逐步临床推理指南,包括获得和记录同意的过程。参与者就需要修订或删除的指南的个别部分提出了建议。修订后的指南一旦获得批准,需要以书面和电子格式分发给所有临床医生。需要进行培训和教育,以确保在专业内外得到适当的采纳。
结论和意义
为了确保其临床接受度和实用性,修订后的指南需要反映肌肉骨骼物理治疗师的当前使用和建议。然后需要进行合理的知识转化过程,以确保指南被纳入实践。