School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Highfield Campus Building 67, University Road, Southampton, Hampshire, SO17 1BJ, UK.
School of Clinical Sciences, Auckland University of Technology, Auckland, NZ, New Zealand.
J Foot Ankle Res. 2021 May 12;14(1):39. doi: 10.1186/s13047-021-00478-4.
Podiatrists, in musculoskeletal services, are demonstrating an expansion of their practice skills through the use of ultrasound imaging. There is an assumption that this practice is beneficial within the context of patient care and health systems. The aim of this research was to further investigate the use of musculoskeletal ultrasound (MSUS) by podiatrists within their clinical setting and gain additional insights into the impact that they perceive use of MSUS has on their approaches to management of musculoskeletal foot and ankle problems.
An international study utilising a cross-sectional design and an internet-based platform was undertaken. The survey was developed and implemented through three phases: 1. survey development, 2. face validity agreement via questionnaire review, and 3. survey distribution and data collection. Twenty-two survey questions were developed and set as a two-step approach collecting quantitative data (part 1) and qualitative free text data (part 2). Data was exported from SurveyMonkey and analysed using Microsoft Excel software. Counts and frequencies were calculated for responses to all twenty closed questions. Responses to the two final open-ended questions were analysed using thematic analysis to search for patterns related to podiatrists' perceptions of impact.
Two hundred and thirty-two eligible participants consented to complete the survey. The majority (n = 159) of respondents were from the UK and Spain. Commonly MSUS has been used in practice for (i) diagnosing pathology, (ii) supporting rehabilitation, (iii) supporting interventions or (iv) research purposes. Most frequently, MSUS was used to assist in the diagnosis of injury/pathology (84%). A range of free text comments were received from the participants in response to the question relating to their thoughts on the impact of using MSUS imaging in their practice (n = 109) and on their perceptions of how the use of MSUS has influenced their approaches to management of their patients' musculoskeletal foot and ankle problems (n = 108). Thematic analysis of the free text comments generated four themes: (i) diagnosis, (ii) delivery and access of care, (iii) patient education and engagement, and (iv) patient empowerment.
The perceived benefit podiatrists indicated in using MSUS as part of their practice is the perceived improvement in patient journeys through tighter, focused management plans and reduced waiting times. An additional novel finding was that MSUS provided the capacity for podiatrists to better inform patients of their diagnosis, which they believed led to improved engagement and consequent empowerment of patients in their treatment plans. We propose further investigation of patient experiences as well as testing of the model that embeds podiatrists' use of MSUS as a key skill in musculoskeletal foot and ankle services.
足病医生在肌肉骨骼服务中通过使用超声成像来扩展他们的实践技能。人们假设这种做法在患者护理和卫生系统中是有益的。本研究的目的是进一步调查足病医生在临床环境中使用肌肉骨骼超声（MSUS）的情况，并深入了解他们认为使用 MSUS 对他们管理肌肉骨骼足部和踝关节问题的方法的影响。
利用横断面设计和基于互联网的平台进行了一项国际研究。该调查通过三个阶段进行开发和实施：1. 调查开发，2. 通过问卷审查进行面对面有效性协议，以及 3. 调查分发和数据收集。制定了 22 个调查问题，并设置为两步法，收集定量数据（第 1 部分）和定性自由文本数据（第 2 部分）。从 SurveyMonkey 导出数据，并使用 Microsoft Excel 软件进行分析。对所有 20 个封闭问题的回答进行计数和频率计算。对两个最后一个开放式问题的回答使用主题分析进行分析，以搜索与足病医生对影响的看法相关的模式。
有 232 名符合条件的参与者同意完成调查。大多数（n=159）受访者来自英国和西班牙。通常，MSUS 已在实践中用于 (i) 诊断病理学，(ii) 支持康复，(iii) 支持干预或 (iv) 研究目的。最常使用 MSUS 来协助诊断损伤/病理学（84%）。参与者对与他们在实践中使用 MSUS 成像的想法相关的问题（n=109）以及对他们认为使用 MSUS 如何影响他们管理患者肌肉骨骼足部和踝关节问题的方法的看法做出了各种自由文本评论（n=108）。对自由文本评论进行主题分析产生了四个主题：(i) 诊断，(ii) 护理和就诊的提供，(iii) 患者教育和参与，以及 (iv) 患者赋权。
足病医生在实践中使用 MSUS 作为其治疗方法的一部分所认为的好处是，通过更紧密、更有针对性的管理计划和减少等待时间，改善了患者的就诊体验。一个新的发现是，MSUS 使足病医生能够更好地告知患者他们的诊断，足病医生认为这会提高患者对治疗计划的参与度，从而赋予他们权力。我们建议进一步调查患者的体验，并测试将足病医生使用 MSUS 作为肌肉骨骼足部和踝关节服务的关键技能嵌入其中的模型。
