澳大利亚和新西兰医疗专业人员对银屑病关节炎患者足部问题评估与管理的看法：一项定性研究。
Health professional views on the assessment and management of foot problems in people with psoriatic arthritis in Australia and New Zealand: a qualitative investigation.
作者信息
Carter Kate, Walmsley Steven, Rome Keith, Turner Deborah E
机构信息
Podiatry department, School of Science and Health, Western Sydney University, Building 24, Campbelltown Campus, Sydney, Australia.
Health and Rehabilitation Research Institute, Faculty of Health and Environmental Science, AUT University, 90 Akoranga Drive, Northcote, Auckland, 0627, New Zealand.
出版信息
BMC Musculoskelet Disord. 2019 May 4;20(1):191. doi: 10.1186/s12891-019-2572-6.
BACKGROUND
Active foot disease persists in a high proportion of people with psoriatic arthritis despite the availability of pharmacological and non-pharmacological interventions to modify the course of the disease. Limited information exists on the provision of health care for foot disease in psoriatic arthritis. The objective of this study was to explore the views of health professionals on the assessment and management of people with psoriatic arthritis-related foot involvement.
METHODS
Convenience sampling was used to recruit health professionals working in rheumatology outpatient clinics in Sydney, Australia and Auckland, New Zealand. Three focus groups were undertaken to explore the views and experiences of health professionals on the assessment and management of foot problems in people with psoriatic arthritis. All interviews were audio-recorded and transcribed verbatim. Qualitative data was analysed using a constant comparative analytic approach to identify themes.
RESULTS
A total of seventeen health professionals participated including rheumatologists, podiatrists and a physiotherapist. Key themes derived from the focus groups suggest that health professionals perceived that people with psoriatic arthritis-related foot problems experience suboptimal management from symptom onset, to diagnosis and treatment. Frustration was expressed throughout discussions relating to lack of appropriate training and expertise required for the specialised management of foot problems typically encountered with psoriatic arthritis and poor access for patients to specialist podiatry services.
CONCLUSIONS
This study provides new insight into the perspectives of health professionals on the management of foot problems related to psoriatic arthritis. Deficiencies in the diagnosis, assessment and treatment of foot problems were revealed. To meet the foot health needs of people with psoriatic arthritis, reducing diagnostic delay, improving knowledge and awareness about the disease among people with psoriatic arthritis and health professionals, and increasing specialist podiatry service provision may be required.
背景
尽管有药物和非药物干预措施来改变银屑病关节炎的病程，但仍有很大比例的银屑病关节炎患者存在活动性足部疾病。关于银屑病关节炎足部疾病的医疗保健提供情况，现有信息有限。本研究的目的是探讨卫生专业人员对银屑病关节炎相关足部受累患者的评估和管理的看法。
方法
采用便利抽样法招募在澳大利亚悉尼和新西兰奥克兰的风湿病门诊工作的卫生专业人员。开展了三个焦点小组讨论，以探讨卫生专业人员对银屑病关节炎患者足部问题评估和管理的看法及经验。所有访谈均进行了录音，并逐字转录。使用持续比较分析方法对定性数据进行分析，以确定主题。
结果
共有17名卫生专业人员参与，包括风湿病学家、足病医生和一名物理治疗师。焦点小组得出的关键主题表明，卫生专业人员认为，银屑病关节炎相关足部问题患者从症状出现到诊断和治疗，其管理都未达到最佳状态。在整个讨论过程中，人们对银屑病关节炎常见足部问题的专业管理所需的适当培训和专业知识的缺乏，以及患者难以获得专科足病服务表示沮丧。
结论
本研究为卫生专业人员对银屑病关节炎相关足部问题管理的观点提供了新的见解。揭示了足部问题在诊断、评估和治疗方面的不足。为满足银屑病关节炎患者的足部健康需求，可能需要减少诊断延迟，提高银屑病关节炎患者和卫生专业人员对该疾病的认识和了解，并增加专科足病服务的提供。
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