Simmons University, Boston, Massachusetts, USA.
MGH Institute of Health Professions, Boston, Massachusetts, USA.
Phys Ther. 2021 Jun 1;101(6). doi: 10.1093/ptj/pzab088.
The purpose of this study was to investigate the physical therapy process of care, clinical practices, and the self-reported psychosocial impact of working during the 2020 pandemic on physical therapists and physical therapist assistants.
An electronic survey including closed and open-ended questions was distributed to physical therapists employed in a range of health care settings across the United States.
Physical therapy use and process of care varied across settings. Feasibility of performing an assessment was the main driver for selection of outcome measures. Interventions were mainly geared toward improving respiratory function and deconditioning. Prone patient positioning, now commonplace, was used infrequently by therapists in acute care prior to coronavirus disease 2019 (COVID-19). Similarly, outpatient and home care settings noted an increase in the use of respiratory-driven interventions such as incentive spirometry and breathing exercises. Qualitative data analysis revealed both physical barriers (personal protective equipment [PPE]) and social barriers to care. Therapists noted challenges in discharge planning and patient/family education due to the impact of social isolation. They also noted difficulty maintaining productivity standards because of additional time spent in changing PPE and following safety measures. Participants dealt with rapid changes in their role, changing productivity standards, and needing to increase their knowledge in a short amount of time.
Physical therapy use varied widely across settings. Despite some concern for personal health, respondents felt that the COVID-19 pandemic increased a sense of togetherness among team members and promoted greater appreciation for life and work.
This exploration of the process of care and current clinical practices across settings provides important knowledge about the role of physical therapists and physical therapist assistants in the care of patients with COVID-19. Gaining an understanding of the psychosocial impact of the pandemic among therapists could assist in creating solutions to better support clinicians' well-being.
本研究旨在调查物理治疗师在 2020 年大流行期间工作时的治疗过程、临床实践以及自我报告的心理社会影响。
向美国各地不同医疗保健环境中工作的物理治疗师发送了一份包含封闭式和开放式问题的电子调查。
物理治疗的使用和治疗过程因环境而异。进行评估的可行性是选择结果测量的主要驱动因素。干预措施主要侧重于改善呼吸功能和去适应。俯卧位患者体位现在很常见，但在 2019 年冠状病毒病（COVID-19）之前，急性护理中的治疗师很少使用。同样，门诊和家庭护理环境也注意到呼吸驱动干预措施（如激励性肺活量计和呼吸练习）的使用增加。定性数据分析揭示了物理障碍（个人防护设备[PPE]）和社会障碍对护理的影响。治疗师注意到由于社会隔离的影响，在出院计划和患者/家庭教育方面存在挑战。他们还注意到由于花费额外的时间更换 PPE 并遵循安全措施，难以维持生产标准。参与者迅速改变了他们的角色，改变了生产标准，并需要在短时间内增加他们的知识。
物理治疗的使用在不同的环境中差异很大。尽管有些人担心个人健康，但受访者认为 COVID-19 大流行增加了团队成员之间的团结感，并促进了对生活和工作的更大欣赏。
对不同环境中的治疗过程和当前临床实践的探索提供了有关物理治疗师和物理治疗助理在 COVID-19 患者护理中的作用的重要知识。了解治疗师对大流行的心理社会影响可能有助于制定更好地支持临床医生健康的解决方案。
