养老院中的物理疗法。对物理治疗师观点和经验的定性研究。
Physiotherapy in nursing homes. A qualitative study of physiotherapists' views and experiences.
机构信息
Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.
Department of Physiotherapy, Aafje Nursing Homes, Rotterdam, The Netherlands.
出版信息
BMC Geriatr. 2021 Mar 1;21(1):150. doi: 10.1186/s12877-021-02080-6.
BACKGROUND
There are distinct differences in the implementation of physiotherapeutic care in nursing homes. Both nationally and internationally staffing levels of physiotherapy differ significantly between and within nursing homes. Since legislation or guidelines that specify the parameters of physiotherapy required in nursing homes are lacking, it is unknown how physiotherapists currently estimate the usefulness and necessity of physiotherapy in individual situations in long-term care. The purpose of this study was to describe how physiotherapists actually work, and how they want to work, in daily practice in Dutch nursing homes.
METHODS
We performed a qualitative study with an online questionnaire. We asked 72 physiotherapists working in Dutch nursing homes to describe as accurately as possible usual care in nine different cases in long-term care. Furthermore we asked them to describe their role in the prevention and treatment of a number of indicators that measure the quality of care in nursing homes. Two reviewers thematically analysed the answers to the questionnaires.
RESULTS
Forty-six physiotherapists returned the questionnaire. Physiotherapy services include active exercise therapy aimed to improve mobility and movement dysfunctions, advising on prevention and management of falls, pressure ulcers, incontinence, malnutrition and sarcopenia, overweight, physical restraints, intertrigo, chronic wounds, behavioural and psychological symptoms in dementia, and physical inactivity, and ergonomic and behavioural training. The way and extent in which physiotherapists are involved in the various care- and functional problems differs and depends on organisational and personal factors such as, organisation's policy, type of ward, time pressure, staffing level, collaboration with other members of the multidisciplinary team, or lack of knowledge.
CONCLUSION
Physiotherapists in nursing homes are involved in the prevention and management of different care situations and functional problems. The way in which they are involved differs between physiotherapist. Aiming for more uniformity seems necessary. A shared vision can help physiotherapists to work more consistently and will strengthen their position in nursing homes.
背景
养老院中物理治疗护理的实施存在明显差异。国内外养老院之间以及养老院内部的物理治疗人员配备水平存在显著差异。由于缺乏规定养老院所需物理治疗参数的法规或指南，目前尚不清楚物理治疗师如何在长期护理的个别情况下评估物理治疗的有用性和必要性。本研究的目的是描述荷兰养老院中物理治疗师在日常实践中的实际工作方式以及他们希望的工作方式。
方法
我们进行了一项定性研究，采用在线问卷调查。我们要求 72 名在荷兰养老院工作的物理治疗师尽可能准确地描述在长期护理的 9 种不同情况下的常规护理。此外，我们还要求他们描述自己在预防和治疗一些衡量养老院护理质量的指标方面的作用。两位评审员对问卷的答案进行了主题分析。
结果
46 名物理治疗师返回了问卷。物理治疗服务包括旨在改善移动性和运动功能障碍的主动运动治疗、预防和管理跌倒、压疮、失禁、营养不良和肌肉减少症、超重、身体约束、间擦疹、慢性伤口、痴呆的行为和心理症状以及身体活动不足，以及人体工程学和行为训练。物理治疗师参与各种护理和功能问题的方式和程度因组织和个人因素而异，例如组织政策、病房类型、时间压力、人员配备水平、与多学科团队其他成员的合作、或缺乏知识。
结论
养老院中的物理治疗师参与预防和管理不同的护理情况和功能问题。他们参与的方式因人而异。实现更统一的目标似乎是必要的。共同的愿景可以帮助物理治疗师更一致地工作，并加强他们在养老院中的地位。
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