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爱尔兰共和国物理治疗师的痴呆症护理经验和教育需求的定性研究。

A qualitative study of the dementia-care experiences and educational needs of physiotherapists in the Republic of Ireland.

机构信息

Department of General Practice, School of Medicine, University College Cork, Ireland.

Discipline of Physiotherapy, School of Clinical Therapies, University College Cork, Ireland.

出版信息

Physiotherapy. 2020 Jun;107:267-274. doi: 10.1016/j.physio.2019.08.006. Epub 2019 Aug 9.

Abstract

OBJECTIVES

Gait disturbance and impaired balance lead to a greater risk of falls and hip fractures for people with dementia. Physiotherapists play an important role in multidisciplinary dementia care. This study aimed to explore physiotherapists' experiences of dementia care and sought to identify their dementia-specific educational needs.

DESIGN

Qualitative design, using focus group interviews.

SETTING

Primary care and secondary care physiotherapy services in the Republic of Ireland.

PARTICIPANTS

Six focus groups with thirty-two physiotherapists, working in community care and hospital settings.

RESULTS

Physiotherapists described a significant dementia-related workload. Challenges to care included absence of a formal diagnosis, clinical uncertainty, scarcity of resources, physical working environment and the assessment of rehabilitation potential. Dementia care was enhanced by the involvement of family members and by collaboration with other allied healthcare professionals. Participants expressed a wish to receive further dementia training and clear evidence-based physiotherapy guidelines. Identified areas of educational need included enhanced communication techniques, use and interpretation of cognitive screening tools, sub-typing of dementia, and ethical issues in dementia care.

CONCLUSIONS

Our findings indicate that physiotherapists remain challenged by complex aspects of dementia care. Tailored dementia training for physiotherapists should be developed, focusing on their educational needs. Delivery of training should incorporate interactive case-based activities and interprofessional education with other allied healthcare professionals.

摘要

目的

步态障碍和平衡受损会增加痴呆患者跌倒和髋部骨折的风险。物理治疗师在多学科痴呆护理中发挥着重要作用。本研究旨在探讨物理治疗师的痴呆护理经验,并确定他们的痴呆特定教育需求。

设计

定性设计,使用焦点小组访谈。

地点

爱尔兰共和国的初级保健和二级保健物理治疗服务。

参与者

来自社区护理和医院环境的 32 名物理治疗师参加了 6 个焦点小组。

结果

物理治疗师描述了与痴呆症相关的大量工作。护理方面的挑战包括缺乏正式诊断、临床不确定性、资源匮乏、物理工作环境以及康复潜力评估。家庭成员的参与以及与其他联合医疗保健专业人员的合作增强了痴呆症护理。参与者表示希望接受进一步的痴呆症培训和明确的基于证据的物理治疗指南。确定的教育需求领域包括增强沟通技巧、认知筛查工具的使用和解释、痴呆症的亚型以及痴呆症护理中的伦理问题。

结论

我们的研究结果表明,物理治疗师仍然面临痴呆症护理复杂方面的挑战。应为物理治疗师制定专门的痴呆症培训,重点关注他们的教育需求。培训的提供应包括互动案例为基础的活动和与其他联合医疗保健专业人员的跨专业教育。

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