Hansell Louise, Milross Maree, Delaney Anthony, Tian David H, Rajamani Arvind, Ntoumenopoulos George
Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Physiotherapy Department, Royal North Shore Hospital, St Leonards, Sydney, Sydney, Australia.
Physiotherapy Department, Royal North Shore Hospital, St Leonards, Sydney, Sydney, Australia.
Aust Crit Care. 2023 Jul;36(4):573-578. doi: 10.1016/j.aucc.2022.04.005. Epub 2022 Jun 7.
Lung ultrasound (LUS) is an emerging tool for acute respiratory physiotherapists. In Australia, there are a select few LUS training courses run for physiotherapists. Research to date has evaluated LUS training courses for physiotherapists in terms of knowledge and skill acquisition. The impact of LUS training on user competence and confidence and whether LUS is used in clinical practice has yet to be evaluated. This study therefore explored the impact of attending a physiotherapy LUS training course on acquisition of competence and confidence and the barriers and facilitators for physiotherapists in achieving competence in LUS.
A quantitative survey containing 21 questions was distributed to 77 Australian physiotherapists.
Of the invited physiotherapists, 39 (50%) completed the survey. Most participants were working in intensive care, in the public hospital setting. Binary logistic regression was performed and demonstrated no significant difference in the relationship between years of clinical experience and having confidence in performing or interpreting LUS images. There was also no statistical significance in the relationship between years of clinical experience and gaining competence and accreditation in LUS. Of the 39 responders, 20 physiotherapists had performed at least one LUS scan since completing training; however, most identified they never use LUS to inform clinical decision-making. Only one physiotherapist had gained accreditation through an ultrasound-governing body. The most frequently reported barriers to achieving competence were lack of clinical time to devote to training and lack of an LUS supervisor.
A majority of physiotherapists who participated in an LUS training course did not attain competence or accreditation, nor were they confident in performing LUS and interpreting images. Barriers exist that prevent intensive care physiotherapists from being able to use LUS in clinical practice. LUS is also not frequently used by acute respiratory physiotherapists to make clinical decisions.
肺部超声（LUS）是急性呼吸治疗师的一种新兴工具。在澳大利亚，为治疗师开设的LUS培训课程寥寥无几。迄今为止的研究已从知识和技能获取方面评估了针对治疗师的LUS培训课程。LUS培训对使用者能力和信心的影响以及LUS是否用于临床实践尚未得到评估。因此，本研究探讨了参加物理治疗LUS培训课程对能力和信心获取的影响，以及治疗师在实现LUS能力方面的障碍和促进因素。
向77名澳大利亚物理治疗师发放了一份包含21个问题的定量调查问卷。
在受邀的物理治疗师中，39人（50%）完成了调查。大多数参与者在公立医院的重症监护室工作。进行了二元逻辑回归分析，结果显示临床经验年限与对执行或解读LUS图像有信心之间的关系无显著差异。临床经验年限与在LUS方面获得能力和认证之间的关系也无统计学意义。在39名受访者中，20名物理治疗师自完成培训后至少进行了一次LUS扫描；然而，大多数人表示他们从未使用LUS来指导临床决策。只有一名物理治疗师通过超声管理机构获得了认证。最常报告的实现能力的障碍是缺乏用于培训的临床时间和缺乏LUS督导。
参加LUS培训课程的大多数物理治疗师未获得能力或认证，他们在执行LUS和解读图像方面也缺乏信心。存在一些障碍阻碍重症监护物理治疗师在临床实践中使用LUS。急性呼吸治疗师也不常使用LUS来做出临床决策。
