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[德国物理治疗护理的适宜性:一项范围综述]

[Appropriateness of physiotherapy care in Germany: a scoping review].

作者信息

Peschke Dirk

机构信息

Department für Angewandte Gesundheitswissenschaften, Studienbereich Physiotherapie Hochschule für Gesundheit Bochum, Bochum, Deutschland; Institut für Public Health und Pflegeforschung (IPP), Universität Bremen, Deutschland.

出版信息

Z Evid Fortbild Qual Gesundhwes. 2019 May;141-142:33-44. doi: 10.1016/j.zefq.2019.03.004. Epub 2019 Apr 16.

Abstract

BACKGROUND

Physiotherapy is applied for various indications in practices, hospitals and rehabilitation facilities and should be delivered according to the patients' needs. Empirical knowledge on the appropriateness of physiotherapy care in Germany is scarce. This scoping review aims to give an overview over the evidence base, to describe the results of previous studies and to evaluate the appropriateness of physiotherapy care.

METHOD

A systematic literature search was conducted in the databases PubMed, CINAHL, LIVIO and SPOLIT. Results were synthesized in a quantitative and qualitative narrative review.

RESULTS

The screening of 1,517 publications yielded 30 studies eligible for inclusion. The included studies encompass 16 different indications. The number of patients with appropriate physiotherapy care varies between indications (from 3 % for urinary incontinence up to 72 % for osteoporosis).

DISCUSSION

The review shows a lack of empirical evidence since sufficient empirical findings regarding the appropriateness of physiotherapy care are missing for many of the indications, in particular on physiotherapy in hospitals and rehabilitation facilities. The results of single studies are limited by insufficient assessment of therapeutic needs or the therapy modalities applied. Analyses which encompass multiple settings and/or providers of care have not been conducted in all studies, even though respective approaches would have been suitable. Nevertheless, suggestions for targeted improvement of the appropriateness of physiotherapy care can be derived from the results.

摘要

背景

物理治疗在诊所、医院和康复机构中有多种应用指征,应根据患者需求提供。在德国,关于物理治疗护理适宜性的实证知识匮乏。本范围综述旨在概述证据基础,描述先前研究的结果,并评估物理治疗护理的适宜性。

方法

在PubMed、CINAHL、LIVIO和SPOLIT数据库中进行了系统的文献检索。结果在定量和定性叙述性综述中进行了综合。

结果

对1517篇出版物的筛选产生了30项符合纳入标准的研究。纳入的研究涵盖16种不同的指征。接受适当物理治疗护理的患者数量因指征而异(从尿失禁的3%到骨质疏松症的72%)。

讨论

该综述表明缺乏实证证据,因为许多指征缺乏关于物理治疗护理适宜性的充分实证结果,特别是关于医院和康复机构中的物理治疗。单项研究的结果受到治疗需求评估不足或所应用治疗方式的限制。即使相应的方法是合适的,但并非所有研究都进行了涵盖多种环境和/或护理提供者的分析。尽管如此,仍可从结果中得出针对性改善物理治疗护理适宜性的建议。

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