Takahashi Tetsuya, Kato Michitaka, Obata Kengo, Kozu Ryo, Fujimoto Toru, Yamashita Koji, Ando Morihide, Kawai Yusuke, Kojima Noriaki, Komatsu Hiroshi, Nakamura Kensuke, Yamashita Yuhei, Patman Shane, Utsunomiya Akemi, Nishida Osamu
Juntendo University, Japan.
Tokoha University, Japan.
Phys Ther Res. 2020 Nov 25;24(1):52-68. doi: 10.1298/ptr.E10060. eCollection 2021.
Early mobilization and rehabilitation has become common and expectations for physical therapists working in intensive care units have increased in Japan. The objective of this study was to establish consensus-based minimum clinical practice standards for physical therapists working in intensive care units in Japan. It also aimed to make an international comparison of minimum clinical practice standards in this area.
In total, 54 experienced physical therapists gave informed consent and participated in this study. A modified Delphi method with questionnaires was used over three rounds. Participants rated 272 items as "essential/unknown/non-essential". Consensus was considered to be reached on items that over 70% of physical therapists rated as "essential" to clinical practice in the intensive care unit.
Of the 272 items in the first round, 188 were deemed essential. In round 2, 11 of the 62 items that failed to reach consensus in round 1 were additionally deemed essential. No item was added to the "essential" consensus in round 3. In total, 199 items were therefore deemed essential as a minimum standard of clinical practice. Participants agreed that 42 items were not essential and failed to reach agreement on 31 others. Identified 199 items were different from those in the UK and Australia due to national laws, cultural and historical backgrounds.
This is the first study to develop a consensus-based minimum clinical practice standard for physical therapists working in intensive care units in Japan.
在日本，早期活动与康复已变得普遍，对在重症监护病房工作的物理治疗师的期望也有所提高。本研究的目的是为日本重症监护病房的物理治疗师制定基于共识的最低临床实践标准。它还旨在对该领域的最低临床实践标准进行国际比较。
共有54名经验丰富的物理治疗师签署知情同意书并参与本研究。采用经过改进的德尔菲问卷调查法，共进行三轮。参与者将272项内容评为“必要/未知/非必要”。对于超过70%的物理治疗师认为对重症监护病房临床实践“必要”的项目，视为达成共识。
第一轮的272项内容中，188项被认为是必要的。在第二轮中，第一轮未达成共识的62项内容中有11项被额外认定为必要。第三轮没有项目被添加到“必要 ”共识中。因此，总共199项被视为临床实践的最低标准。参与者一致认为42项非必要，另有31项未达成一致意见。由于国家法律、文化和历史背景，确定的199项内容与英国和澳大利亚的不同。
这是第一项为日本重症监护病房的物理治疗师制定基于共识的最低临床实践标准的研究。
