物理治疗师对明智选择建议的态度、观点和信念:一项定性研究。

Physiotherapists' attitudes, views, and beliefs about Choosing Wisely recommendations: A qualitative study.

机构信息

Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia.

Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia.

出版信息

Musculoskelet Sci Pract. 2022 Oct;61:102610. doi: 10.1016/j.msksp.2022.102610. Epub 2022 Jun 20.

Abstract

OBJECTIVE

Explore physiotherapists' attitudes, views, and beliefs towards the Australian Physiotherapy Association's (APA) Choosing Wisely recommendations.

DESIGN

Qualitative interview study.

METHODS

We conducted semi-structured interviews with physiotherapists who were registered to practise in Australia. We purposively recruited participants with different demographics, clinical backgrounds, and years of experience to achieve diversity in views and opinions. Interviews explored barriers and facilitators to adopting the APA's Choosing Wisely recommendations, and strategies to increase adoption. Interviews were recorded, transcribed verbatim and analysed thematically.

RESULTS

We interviewed 19 participants (79.2% of 26 who expressed interest to be interviewed). Mean (SD) age of participants was 33.4 (11.6), mean (SD) years of experience was 10 (11.4), 90% were male (n = 17) and 53% worked in private practice (n = 10). Most participants were slightly (42.1%, n = 8) or at least moderately familiar (42.1%, n = 8) with the recommendations. Barriers to adopting the recommendations included 1) clinicians' beliefs, experience, and knowledge, 2) patients' clinical presentation, their beliefs, and expectations, 3) workplace demands and culture, and 4) vague and restrictive language, and lack of awareness. Facilitators to adopting the recommendations included 1) physiotherapists' beliefs and practise patterns, 2) organisational support, and 3) clear and appropriate recommendations. Suggested strategies to increase adoption of the recommendations were 1) interventions targeting clinicians, 2) amendments to the recommendations and 3) increased awareness and access to the recommendations.

CONCLUSION

These findings will inform the development and dissemination of future Choosing Wisely recommendations, and development of strategies to replace low-value physiotherapy with high-value physiotherapy.

LEVEL OF EVIDENCE

IV.

摘要

目的

探讨物理治疗师对澳大利亚物理治疗协会(APA)明智选择建议的态度、看法和信念。

设计

定性访谈研究。

方法

我们对在澳大利亚注册执业的物理治疗师进行了半结构化访谈。我们有目的地招募了具有不同人口统计学、临床背景和工作经验的参与者,以实现观点和意见的多样性。访谈探讨了采用 APA 明智选择建议的障碍和促进因素,以及增加采用建议的策略。访谈进行了录音,逐字转录并进行了主题分析。

结果

我们采访了 19 名参与者(表达过接受采访意向的 26 名中的 79.2%)。参与者的平均(标准差)年龄为 33.4(11.6)岁,平均(标准差)工作年限为 10(11.4)年,90%为男性(n=17),53%在私人诊所工作(n=10)。大多数参与者对建议略为熟悉(42.1%,n=8)或至少较为熟悉(42.1%,n=8)。采用这些建议的障碍包括 1)临床医生的信念、经验和知识,2)患者的临床表现、他们的信念和期望,3)工作场所的需求和文化,以及 4)模糊和限制的语言以及缺乏意识。采用建议的促进因素包括 1)物理治疗师的信念和实践模式,2)组织支持,以及 3)清晰且适当的建议。增加采用建议的建议策略包括 1)针对临床医生的干预措施,2)对建议的修订,以及 3)提高对建议的认识和获取途径。

结论

这些发现将为明智选择建议的制定和传播提供信息,并为用高价值物理治疗替代低价值物理治疗制定策略。

证据水平

IV。

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