School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia.
Physiotherapy Department, Royal Brisbane and Womens Hospital, Brisbane, Australia.
Musculoskeletal Care. 2020 Jun;18(2):161-168. doi: 10.1002/msc.1448. Epub 2020 Jan 26.
Successful management of musculoskeletal conditions depends on active patient engagement and uptake of recommended health services and self-management strategies. Clinicians have a strong influence on patient uptake behaviours. Both clinicians and educators need to recognise the clinician's influence on patient uptake as a specific clinical skillset to be professionally developed. To inform professional development strategies this study explored priority clinician attributes that underpin the clinical skillset of fostering patient uptake.
A three-round Delphi process engaged relevant stakeholders including a professional panel (clinicians, health managers, education providers) and a patient panel. Panel members deliberated and reached consensus regarding key attributes required by allied health clinicians who manage patients with musculoskeletal disorders to optimize patient uptake behaviours. In the final round, panel members rated the importance of each attribute on a numerical rating scale.
Overall 12 attributes were finalised. Both the professional and the patient panel provided a high rating of importance for all finalised attributes with 'patient centred communication' rated the highest importance (median scores 9.5-10/10) and 'contemporary electronics and media' rated the lowest (median scores 6-7/10).
There appears to be agreement on a basic inventory of clinician attributes which positively influence patient uptake when managing musculoskeletal conditions. Professional development and training programs for clinicians managing musculoskeletal conditions may need to consider discipline relevant aspects of these attributes to advance the development of clinicians in this aspect of professional practice to attain better patient outcomes.
成功管理肌肉骨骼疾病取决于患者积极参与并接受推荐的医疗服务和自我管理策略。临床医生对患者的接受程度有很大的影响。临床医生和教育者都需要认识到,促进患者接受度是一种特定的临床技能,需要专业发展。为了为专业发展策略提供信息,本研究探讨了支持促进患者接受度的临床技能的优先临床属性。
三轮 Delphi 流程让相关利益相关者参与,包括专业小组(临床医生、健康管理人员、教育提供者)和患者小组。小组成员就管理肌肉骨骼疾病患者的治疗师需要具备的关键属性进行了审议并达成共识,以优化患者接受度行为。在最后一轮,小组成员对每个属性的重要性进行了数字评分。
共有 12 个属性最终确定。专业小组和患者小组都对所有最终确定的属性给予了高度的重要性评价,其中“以患者为中心的沟通”的评价最高(中位数为 9.5-10/10),“现代电子和媒体”的评价最低(中位数为 6-7/10)。
在管理肌肉骨骼疾病时,积极影响患者接受度的临床医生属性似乎存在基本共识。管理肌肉骨骼疾病的临床医生的专业发展和培训计划可能需要考虑这些属性与学科相关的方面,以促进临床医生在这方面的专业实践发展,从而获得更好的患者结果。