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理论导向的临床实践:物理治疗师如何利用基本干预措施解决健康的社会决定因素。

Theory-Informed Clinical Practice: How Physical Therapists Can Use Fundamental Interventions to Address Social Determinants of Health.

机构信息

Division of Physical Therapy, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.

Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.

出版信息

Phys Ther. 2021 Oct 1;101(10). doi: 10.1093/ptj/pzab158.

Abstract

UNLABELLED

The American Physical Therapy Association's Vision Statement for the profession is guided by principles of innovation, access, equity, and advocacy, and calls on physical therapists to stretch their influence beyond the walls of the clinic and the individuals they treat. Access and equity are problems that span multiple health care professions and entities; yet, addressing social determinants of health is a paradigm shift that clinicians need continued support to achieve. This article has 2 objectives: (1) to define the Fundamental Cause Theory and the Socioecological Model within the context of physical therapy in order to promote best clinical practice, and (2) to apply the concept of "fundamental interventions" in clinical practice to mitigate the negative impact of downstream effects of social determinants of health across levels of the Socioecological Model-individual, interpersonal, institutional, community, and societal. This theoretical lens provides the conceptual framework necessary for physical therapists to think creatively about ways to change their practice in their own contexts to impact the life of individual patients and transform the movement health of society.

IMPACT

As health care providers, physical therapists have a responsibility to make every effort to meet the needs of their patients and optimize movement health in society; yet significant structural and systemic barriers often prevent patients from reaching their fullest potential. Clinicians can no longer subscribe to a narrow scope of practice focused on individual attainment of therapy goals. This Perspective discusses Fundamental Cause Theory and the Socioecological Model theoretical frameworks that can help physical therapists develop, test, and implement functional interventions to address the needs of society as a whole.

摘要

未加标签

美国物理治疗协会的专业愿景声明以创新、可及性、公平和倡导原则为指导,并呼吁物理治疗师将其影响力从诊所和他们治疗的个人扩展到诊所之外。可及性和公平是跨越多个医疗保健专业和实体的问题;然而,解决健康的社会决定因素是一种范式转变,临床医生需要持续的支持才能实现。本文有 2 个目标:(1)在物理治疗的背景下定义基本原因理论和社会生态学模型,以促进最佳临床实践,(2)在临床实践中应用“基本干预”的概念,以减轻社会决定因素对健康的下游影响在社会生态模型的各个层次上的负面影响——个人、人际、机构、社区和社会。这一理论视角为物理治疗师提供了必要的概念框架,使他们能够创造性地思考如何在自己的环境中改变实践,以影响个体患者的生活并改变社会的运动健康。

影响

作为医疗保健提供者,物理治疗师有责任尽一切努力满足患者的需求并优化社会的运动健康;然而,重大的结构性和系统性障碍常常阻止患者充分发挥潜力。临床医生不能再局限于关注个人实现治疗目标的狭隘实践范围。本观点讨论了基本原因理论和社会生态学模型理论框架,这些框架可以帮助物理治疗师制定、测试和实施功能干预措施,以满足整个社会的需求。

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