在骨关节炎中实施与生活方式相关的治疗方法的障碍和促进因素：初级和二级保健专业人员的横断面研究。

Barriers and facilitators for implementing lifestyle-related treatment modalities in osteoarthritis: A cross-sectional study among primary and secondary healthcare professionals.

机构信息

Department of Orthopedics, University of Groningen, University Medical Center Groningen, PO Box 30.001, Groningen 9700 RB, The Netherlands.

出版信息

Health Policy. 2023 Oct;136:104898. doi: 10.1016/j.healthpol.2023.104898. Epub 2023 Aug 21.

DOI:10.1016/j.healthpol.2023.104898

PMID:37657360

Abstract

PURPOSE

To identify barriers and facilitators as perceived by primary and secondary healthcare professionals (HCPs) when implementing lifestyle-related treatment modalities (LRTMs) in patients with hip/knee osteoarthritis (OA).

METHODS

A cross-sectional study. A Dutch online survey was distributed among eight different disciplines of primary and secondary HCPs. Potential barriers and facilitators were identified based on participants' responses to 32 research-derived statements on implementing LRTMs, and presented as factors with "major agreement" (≥75%), "minor agreement" (60-75%) or "no agreement" (<60%).

RESULTS

213 participants completed the survey. Seven "barriers" and 20 "facilitators" were identified. There were three "major agreement barriers": organization of Dutch healthcare system, audits within organization, and lifestyle climate in Dutch society. The top three "major agreement facilitators" were: health effects on patients, safety of increasing physical activity, and personal attitude. The total number of "barriers" differed per HCP discipline, with the highest number (12) among orthopedic surgeons (or in-training) and the lowest number (4) among dieticians, physiotherapists, and lifestyle counselors.

CONCLUSIONS

The findings suggest that implementing LRTMs within OA care could be improved by focusing on societal rather than individual HCP factors. National preventive policies on health promotion could counteract the expected increase in healthcare demand and costs due to OA and other chronic diseases. Future research is needed to match relevant implementation strategies to all barriers identified.

摘要

目的

确定初级和二级医疗保健专业人员（HCP）在为髋/膝关节骨关节炎（OA）患者实施与生活方式相关的治疗模式（LRTM）时所感知到的障碍和促进因素。

方法

这是一项横断面研究。一项荷兰在线调查分发给初级和二级 HCP 的八个不同学科。根据参与者对 32 项关于实施 LRTM 的研究衍生陈述的回答，确定潜在的障碍和促进因素，并将其呈现为具有“主要共识”（≥75％）、“次要共识”（60-75％）或“无共识”（<60％）的因素。

结果

213 名参与者完成了调查。确定了 7 个“障碍”和 20 个“促进因素”。有三个“主要共识障碍”：荷兰医疗保健系统的组织、组织内的审计以及荷兰社会的生活方式氛围。前三个“主要共识促进因素”是：对患者的健康影响、增加体力活动的安全性以及个人态度。每个 HCP 学科的“障碍”数量不同，骨科医生（或培训中）最多（12 个），营养师、物理治疗师和生活方式顾问最少（4 个）。