Lawford Belinda J, Bennell Kim L, Kasza Jessica, Campbell Penny K, Gale Janette, Bills Caroline, Hinman Rana S
Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Musculoskeletal Care. 2019 Jun;17(2):221-233. doi: 10.1002/msc.1395. Epub 2019 Apr 12.
The aims of the present study were to determine how well physiotherapists implemented person-centred practice principles and behaviour change techniques after a workshop, and to evaluate whether self-audit of performance differed from audits of an experienced training facilitator.
Eight physiotherapists each completed a 2-day workshop followed by two telephone consultations with four patients with knee osteoarthritis. The training facilitator audited audio-recordings of all consultations, and therapists self-audited 50% of consultations using a tool comprising: (a) 10 person-centred practice principles rated on a numerical rating scale of 0 (need to work on this) to 10 (doing really well); and (b) seven behaviour change techniques rated with an ordinal scale (using this technique effectively; need to improve skill level; or need to learn how to apply this technique).
Physiotherapists showed "moderate" fidelity to person-centred principles, with mean scores between 5 and 7 out of 10. For behaviour change techniques, the training facilitator believed that physiotherapists were using three of seven techniques "effectively" during most consultations and "needed to improve skill levels" with most other techniques. Physiotherapists scored themselves significantly lower than the training facilitator for two of 10 person-centred principles, and tended to rate their skills using behaviour change techniques less favourably.
Physiotherapists performed moderately well when implementing person-centred practice principles and behaviour change techniques immediately after training, but had room for improvement, particularly for skills relating to providing management options and changing thinking habits. Physiotherapists' self-ratings of performance generally did not differ from expert ratings; however, they underestimated their ability to implement some principles and techniques.
本研究的目的是确定物理治疗师在参加一个工作坊后,在多大程度上贯彻了以患者为中心的实践原则和行为改变技巧,并评估自我绩效评估与经验丰富的培训指导者的评估是否存在差异。
八名物理治疗师各自参加了一个为期两天的工作坊,随后与四名膝骨关节炎患者进行了两次电话咨询。培训指导者对所有咨询的录音进行了评估,治疗师使用一种工具对50%的咨询进行了自我评估,该工具包括:(a)10条以患者为中心的实践原则,采用从0(需要改进)到10(做得非常好)的数字评分量表进行评分;(b)七条行为改变技巧,采用顺序量表进行评分(有效使用该技巧;需要提高技能水平;或需要学习如何应用该技巧)。
物理治疗师对以患者为中心的原则表现出“中等”的忠诚度,平均得分在5到7分(满分10分)之间。对于行为改变技巧,培训指导者认为物理治疗师在大多数咨询中有效地使用了七条技巧中的三条,而对于大多数其他技巧“需要提高技能水平”。在10条以患者为中心的原则中,有两条原则物理治疗师给自己的评分明显低于培训指导者,并且他们对自己使用行为改变技巧的技能评价往往较低。
物理治疗师在培训后立即实施以患者为中心的实践原则和行为改变技巧时表现中等,但仍有改进空间,特别是在提供管理方案和改变思维习惯方面的技能。物理治疗师的自我绩效评分总体上与专家评分没有差异;然而,他们低估了自己实施某些原则和技巧的能力。