Monash University, Melbourne, Victoria, Australia.
Monash University and Medibank Private Limited, Melbourne, Victoria, Australia.
Arthritis Care Res (Hoboken). 2020 Aug;72(8):1087-1095. doi: 10.1002/acr.23996. Epub 2020 Jun 11.
To investigate physical therapists' knowledge, beliefs, and current practices around falls prevention in osteoarthritis (OA) care.
Currently registered, practicing Australian physical therapists who care for patients with hip and/or knee OA were invited to participate in this cross-sectional study. A comprehensive online survey was used to collect data that were analyzed descriptively or using chi-square tests; free-text responses were classified into key themes for analysis.
Complete responses were received from 370 eligible physical therapists, with broad representation across Australian states and practice settings. Participants worked in public and private hospitals, community health centers, private practices, and aged-care facilities. The sample ranged from new graduates to experienced physical therapists (47% had practiced ≥11 years). Despite the majority having specific training or access to educational resources, physical therapists reported only moderate confidence in assessing falls risk (median 7 [interquartile range (IQR) 6-8]; range 0 [not at all confident] to 10 [extremely confident]) and delivering falls prevention care (median 7 [IQR 6-8]). While most participants asked about falls history (88%), only 39% used falls-risk screening tools, and of these, relatively few used appropriate tools. Time constraints (including competing clinical priorities) were the most frequently perceived barrier to including falls prevention activities within OA care.
This national snapshot of contemporary OA practice has revealed clear opportunities for optimizing clinician confidence and skills to facilitate the uptake of best-practice falls prevention strategies. Improving practice in this area may yield substantial benefits to patients and the health system if more falls can be prevented.
调查物理治疗师在骨关节炎（OA）护理中预防跌倒的知识、信念和当前实践情况。
邀请目前在澳大利亚注册并为髋部和/或膝关节 OA 患者提供护理的执业物理治疗师参与这项横断面研究。使用综合在线调查收集数据，对数据进行描述性或卡方检验分析；对自由文本回复进行分类，归入关键主题进行分析。
收到了 370 名符合条件的物理治疗师的完整回复，这些治疗师在澳大利亚各州和实践环境中都有广泛的代表性。参与者在公立医院和私立医院、社区卫生中心、私人诊所和老年护理机构工作。样本范围从新毕业生到经验丰富的物理治疗师（47%的人有≥11 年的从业经验）。尽管大多数人接受过特定的培训或可以获得教育资源，但物理治疗师报告说，他们评估跌倒风险（中位数为 7 [四分位距 6-8]；范围为 0 [完全没有信心]至 10 [非常有信心]）和提供跌倒预防护理的信心仅为中等（中位数为 7 [四分位距 6-8]）。尽管大多数参与者询问了跌倒史（88%），但只有 39%使用了跌倒风险筛查工具，而在这些工具中，相对较少的人使用了合适的工具。时间限制（包括竞争的临床优先事项）是最常被认为将跌倒预防活动纳入 OA 护理的障碍。
本项针对当代 OA 实践的全国性快照揭示了明显的机会，可以提高临床医生的信心和技能，以促进最佳实践跌倒预防策略的采用。如果能减少更多的跌倒，那么在这一领域改善实践可能会给患者和卫生系统带来巨大的益处。
