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家庭医生和物理治疗师在法国多学科初级保健中心之间共享和转移任务模式的可接受性:一项横断面调查。

Acceptability of a task sharing and shifting model between family physicians and physiotherapists in French multidisciplinary primary healthcare centres: a cross-sectional survey.

机构信息

Themas Team, TIMC-IMAG Laboratory, UMR CNRS-UGA, Grenoble, France

Department of Physiotherapy, University Grenoble-Alpes, Grenoble, Auvergne-Rhône-Alpes, France.

出版信息

Fam Med Community Health. 2022 Jun;10(2). doi: 10.1136/fmch-2022-001644.

Abstract

OBJECTIVES

The rising prevalence of musculoskeletal disorders increases pressure on primary care services. In France, patients with musculoskeletal disorders are referred to physiotherapist (PT) by family physician (FP). To improve access to musculoskeletal care, a new model of task sharing and shifting is implemented between FPs and PTs for patients with acute low back pain. This new model enables French PTs to expand their usual scope of practice by receiving patients as first-contact practitioner, diagnosing low back pain, prescribing sick leave and analgesic medication. The aim of this study is to investigate the acceptability of FPs and PTs regarding this new model.

DESIGN

A cross-sectional survey design was used. Acceptability was measured using a questionnaire on the perception of the model and the perception of PTs' skills to manage low back pain. Descriptive analyses were performed to compare results among participants.

SETTING

French FPs and PTs working in multidisciplinary primary healthcare centres were invited to complete an online survey.

PARTICIPANTS

A total of 174 respondents completed the survey (81 FPs and 85 PTs).

RESULTS

A majority of participants had a positive perception of the task sharing and shifting model. A majority of the participants were mostly or totally favourable towards the implementation of the model (FPs: n=46, 82% and PTs: n=40, 82%). The perceived level of competencies of PTs to manage acute low back pain was high. The confidence level of FPs was higher than that of PTs regarding PTs' ability to adequately diagnose low back pain, refer patient to physiotherapy and prescribe sick leave or analgesic medication.

CONCLUSION

Based on this limited sample of participants, there appears to be good acceptability of the task sharing and shifting model for acute low back pain. Additional studies are needed to better determine the factors affecting the acceptability of such a model.

摘要

目的

肌肉骨骼疾病的患病率不断上升,给初级保健服务带来了压力。在法国,肌肉骨骼疾病患者由家庭医生(FP)转介给物理治疗师(PT)。为了改善肌肉骨骼疾病的治疗机会,FP 和 PT 之间实施了一种新的任务分担和转移模式,用于治疗急性腰痛患者。这种新模式使法国的 PT 能够扩大其常规实践范围,接收患者作为第一接触治疗师,诊断腰痛,开具病假和止痛药物。本研究旨在调查 FP 和 PT 对新模式的可接受性。

设计

采用横断面调查设计。使用关于对该模型的感知和对 PT 管理腰痛能力的感知的问卷来衡量可接受性。进行描述性分析以比较参与者之间的结果。

设置

邀请在多学科初级保健中心工作的法国 FP 和 PT 完成在线调查。

参与者

共有 174 名受访者完成了调查(81 名 FP 和 85 名 PT)。

结果

大多数参与者对任务分担和转移模式有积极的看法。大多数参与者非常或完全支持该模型的实施(FP:n=46,82%和 PT:n=40,82%)。PT 管理急性腰痛的能力被认为具有较高的能力水平。FP 的信心水平高于 PT,FP 对 PT 诊断腰痛、将患者转介至物理治疗以及开具病假或止痛药物的能力更有信心。

结论

基于这有限数量的参与者样本,急性腰痛的任务分担和转移模式似乎具有良好的可接受性。需要进一步研究以更好地确定影响这种模式可接受性的因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7bf/9204406/7ed99236f9bd/fmch-2022-001644f01.jpg

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