Prince Tamira, Cahalin Lawrence P, Cohen Meryl, Hartley Gregory W, Kirk-Sanchez Neva, Roach Kathryn E
Department of Physical Therapy, Miller School of Medicine University of Miami Coral Gables Florida USA.
Health Sci Rep. 2024 Aug 13;7(8):e2307. doi: 10.1002/hsr2.2307. eCollection 2024 Aug.
The purpose of this study was to compare the knowledge and practices of specialist and experienced nonspecialist physical therapists in performing patient education about physical activity with patients with heart failure (HF).
Responses on a nationwide anonymous online survey were used to compare specialist and experienced nonspecialist physical therapists on knowledge and frequency of providing physical activity related education to patients hospitalized with acutely decompensated HF. Responses to survey items were scored on 5-point scales ranging from "Strongly agree" to "Strongly disagree" or "Always" to "Never." Mann-Whitney statistics were used to compare specialist and experienced nonspecialist responses and Wilcoxon signed-ranks tests were used to examine the gap between knowledge and practice.
Twenty-seven specialists and 43 experienced nonspecialists completed the survey. Both groups were similar in age, and experience treating patients hospitalized with acutely decompensated HF. Both groups "strongly agree" that they had the required knowledge and skills to educate patients with HF on the physical activity topics. However, specialists more often than experienced nonspecialists provided education on topics such as how to monitor vital signs during physical activity ("most of the time" vs. "about half of the time") that promoted patient confidence and safety during exercise. Specialists demonstrated a smaller gap between knowledge and frequency of providing patient education than experienced nonspecialists on three of the four patient education topics.
Specialist physical therapists treating patients with HF in the inpatient hospital setting provided patient education on physical activity at a level more closely matching their skills and the clinical practice guideline than did experienced nonspecialists. Physical therapy clinical specialists practicing in the inpatient hospital setting may improve patient outcomes and lower costs to the health care system by improving physical activity adherence and thereby may reduce avoidable hospital readmissions.
本研究旨在比较专科及经验丰富的非专科物理治疗师在对心力衰竭（HF）患者进行体育活动相关患者教育方面的知识和实践情况。
通过一项全国性匿名在线调查的回复，比较专科及经验丰富的非专科物理治疗师在为急性失代偿性HF住院患者提供体育活动相关教育的知识和频率。对调查项目的回答采用从“强烈同意”到“强烈不同意”或从“总是”到“从不”的5分制评分。采用曼-惠特尼统计量比较专科和经验丰富的非专科的回答，并采用威尔科克森符号秩检验来检验知识与实践之间的差距。
27名专科物理治疗师和43名经验丰富的非专科物理治疗师完成了调查。两组在年龄以及治疗急性失代偿性HF住院患者的经验方面相似。两组均“强烈同意"他们具备就体育活动主题对HF患者进行教育所需的知识和技能。然而，专科物理治疗师比经验丰富的非专科物理治疗师更常提供关于如何在体育活动期间监测生命体征等主题的教育（“大多数时候”对“大约一半时间”），这提高了患者运动期间的信心和安全性。在四个患者教育主题中的三个方面，专科物理治疗师在提供患者教育的知识和频率之间的差距比经验丰富的非专科物理治疗师小。
在住院环境中治疗HF患者的专科物理治疗师在提供体育活动相关患者教育方面，其水平比经验丰富的非专科物理治疗师更符合他们的技能和临床实践指南。在住院环境中执业的物理治疗临床专科医生可通过提高体育活动依从性来改善患者预后并降低医疗保健系统成本，从而可能减少可避免的住院再入院情况。
