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Physiotherapy management of adults with asthma: A survey of New Zealand practice 成人哮喘患者的物理治疗管理:新西兰实践调查
Q3 Health Professions Pub Date : 2024-07-26 DOI: 10.15619/nzjp.v52i2.340
Sarah Mooney, Zoë Manderson, Jordyn Healy, Georigia Keech
The role of physiotherapy in adult asthma management in New Zealand is unknown. Contemporary guidelines, including NZ Adolescent and Adult Asthma Guidelines (NZA & AAG), make little reference to physiotherapy. An electronic survey was undertaken to explore the role of physiotherapy in New Zealand in the management of adults with asthma, including what assessment and management techniques were used, self-reported confidence in these techniques, and guiding documents that informed practice. Findings from 59 respondents indicated that New Zealand physiotherapists were not only undertaking generic assessment and management techniques but provided a unique physiotherapy-specific role including breathing retraining and airway clearance techniques. Areas of reduced confidence were identified to guide future training and advanced practice. Physiotherapists were also well placed to influence social determinants at a policy level. While the response rate was limited, this study provides a useful insight into physiotherapy practice in New Zealand in the management of adults with asthma and identifies areas for more holistic practice, as well as future professional advancement.
物理治疗在新西兰成人哮喘治疗中的作用尚不清楚。包括《新西兰青少年和成人哮喘指南》(NZA & AAG)在内的当代指南很少提及物理治疗。我们进行了一项电子调查,以了解物理治疗在新西兰成人哮喘管理中的作用,包括使用了哪些评估和管理技术、自我报告对这些技术的信心以及指导实践的文件。59 位受访者的调查结果表明,新西兰物理治疗师不仅采用了通用的评估和管理技术,还提供了独特的物理治疗特定角色,包括呼吸再训练和气道清理技术。调查还发现了信心不足的领域,以指导未来的培训和高级实践。物理治疗师还能在政策层面对社会决定因素产生影响。虽然回复率有限,但这项研究对新西兰物理治疗在成人哮喘患者管理方面的实践提供了有益的启示,并确定了更全面的实践领域以及未来的专业发展方向。
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引用次数: 0
How do novice physiotherapists describe their experiences of workplace support? 物理治疗师新手如何描述他们在工作场所获得支持的经历?
Q3 Health Professions Pub Date : 2024-07-26 DOI: 10.15619/nzjp.v52i2.394
Christine Cummins, K. Waterworth, Louise Søgaard Hansen, Amy Neal, Vishakha Murthy
This study aimed to explore how the experiences of workplace support contributed to the developing professional confidence, competence, and workplace experience of the novice physiotherapist working in Aotearoa New Zealand. Using a qualitative descriptive methodology, 12 registered physiotherapists who had graduated within the last 5 years and were employed in various settings across Aotearoa New Zealand were recruited. They participated in semi structured interviews, which were analysed using reflexive thematic analysis. Three themes described participants’ experiences of support: (a) navigating the transition; (b) building capabilities to achieve professional growth; and (c) fostering relationships in the workplace. The participants valued professional support that helped them navigate the early challenges they encountered as well as various forms of support that assisted them in their career development. Provision of support was hugely varied across settings and employers. Findings from this study may assist novice physiotherapists to gain awareness while navigating their own transition, accessing developmental opportunities, and building connections and competencies as a new practitioner. Additionally, this research could encourage employers to consider how best to support their novice employees.
本研究旨在探讨在新西兰奥特亚罗瓦工作的物理治疗师新手在工作场所获得支持的经历是如何促进其专业信心、能力和工作场所经验的发展的。研究采用定性描述的方法,招募了 12 名在过去 5 年内毕业的注册物理治疗师,他们受雇于新西兰奥特亚罗瓦的各种环境。他们参加了半结构式访谈,并使用反思性主题分析法对访谈内容进行了分析。三个主题描述了参与者获得支持的经历:(a) 引导过渡;(b) 建设能力,实现专业成长;(c) 促进工作场所的关系。参与者重视专业支持,这些支持帮助他们克服了早期遇到的挑战,并提供了各种形式 的支持,帮助他们实现职业发展。不同的环境和雇主提供的支持大相径庭。这项研究的结果可以帮助物理治疗师新手了解自己的转型过程,获得发展机会,并作为一名新从业人员建立联系和能力。此外,这项研究还可以鼓励雇主考虑如何为其新员工提供最佳支持。
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引用次数: 0
Health navigation for people experiencing newly acquired long-term physical disability: A realist-informed integrative review 为新近患上长期肢体残疾的人提供健康导航:基于现实的综合审查
Q3 Health Professions Pub Date : 2024-07-26 DOI: 10.15619/nzjp.v52i2.401
Emily Timothy, Jo Deely, Donna Tietjens, Rachelle Martin
Navigating healthcare complexities can be challenging for disabled people, leading to challenges accessing services when required, and contributing to inequitable outcomes for disabled people and their families. Physiotherapists may be key health providers for people with newly acquired physical disabilities and may experience these navigational complexities themselves. Health navigators have been postulated as one solution and are well established in services for other health conditions such as cancer and mental health. However, navigation services for disabled people are less well developed and implemented. This realist-informed integrative review aimed to articulate and clarify underlying causal processes of health navigation programmes for people with newly acquired long-term physical disability, particularly within the New Zealand context. A two-phase literature search was conducted using integrative review methods. Two primary foci emerged for navigation programmes – a targeted health focus, directed towards reducing secondary complications and better service use and flow, or holistic health focus, directed towards more aspirational outcomes. Nine mechanisms of effect were identified across the spectrum of navigational programmes, with empowerment and self-determination overarching. Our findings are important for synthesising knowledge about existing navigation programmes and clarifying the aims and outcomes of future programmes addressing the navigational needs of disabled people.
对于残疾人来说,如何应对复杂的医疗保健问题可能具有挑战性,导致他们在需要时难以获得服务,并造成残疾人及其家庭的不公平结果。物理治疗师可能是新获得肢体残疾者的主要医疗服务提供者,他们自己也可能经历这些复杂的导航问题。健康导航员被认为是一种解决方案,在癌症和精神健康等其他健康状况的服务中已得到广泛应用。然而,为残疾人提供的导航服务在发展和实施方面却不尽如人意。这篇基于现实的综合综述旨在阐明和澄清针对新获得的长期肢体残疾人士的健康导航计划的基本因果过程,尤其是在新西兰的背景下。我们使用综合评述方法进行了两阶段的文献检索。导航计划有两个主要重点--一个是有针对性的健康重点,旨在减少继发性并发症,改善服务的使用和流程;另一个是整体健康重点,旨在取得更理想的结果。在各种导航计划中,我们发现了九种影响机制,其中最重要的是赋权和自决。我们的研究结果对于综合现有导航计划的知识、明确未来满足残疾人导航需求的计划的目标和结果非常重要。
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引用次数: 0
Perceptions of people with Parkinson’s on non-motor symptoms and functional ability 帕金森病患者对非运动症状和功能能力的看法
Q3 Health Professions Pub Date : 2024-07-26 DOI: 10.15619/nzjp.v52i2.360
Cherie Leung, Leigh Hale, Nicola Swain, P. Jayakaran
Parkinson’s is the fastest-growing neurological disorder worldwide, exhibiting motor and non-motor symptoms. The condition impacts individuals at multiple levels with both motor and non-motor symptoms (NMS). This study qualitatively explored perceptions of people with Parkinson’s (PwP), NMS, and functional ability. Ten PwP took part in semi-structured phone or Zoom interviews. Data were analysed using the General Inductive Approach. Four major themes were identified: (a) diagnosis as a turning point; (b) nonmotor symptoms and functional ability; (c) self-management; and (d) significant others. The themes were further classified into 13 subthemes and 10 categories. Interaction between the four themes also emerged from the data. A complex nuanced impact was found on the relationships between the individual and their significant others. People with Parkinson’s experienced either a “vicious cycle” or a “virtuous cycle” of symptoms, which were dependent on a multitude of factors, for example, whether it is a “good” or “bad” day and the corresponding actions taken on these days. The findings provide key insights into tailoring advice and support into self-management of Parkinson’s, particularly of actions that can be taken for better outcomes.
帕金森病是全球增长最快的神经系统疾病,表现出运动和非运动症状。帕金森病对患者的影响是多方面的,既有运动症状,也有非运动症状(NMS)。本研究对帕金森病患者(PwP)、NMS 和功能能力的看法进行了定性探讨。十名帕金森患者参加了半结构化电话或 Zoom 访谈。研究采用一般归纳法对数据进行了分析。确定了四大主题(a) 作为转折点的诊断;(b) 非运动症状和功能能力;(c) 自我管理;以及 (d) 重要他人。这些主题又分为 13 个次主题和 10 个类别。数据还显示了四个主题之间的相互作用。我们发现,个人与其重要他人之间的关系受到了复杂而微妙的影响。帕金森病患者的症状要么是 "恶性循环",要么是 "良性循环",这取决于多种因素,例如,今天是 "好 "还是 "坏",以及在这些日子里采取的相应行动。研究结果为量身定制帕金森病自我管理的建议和支持提供了重要启示,尤其是可以采取哪些行动来取得更好的效果。
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引用次数: 0
The efficacy of anterior cruciate ligament reconstruction and rehabilitation compared to conservative management for reducing the incidence of post-traumatic osteoarthritis following anterior cruciate ligament injury: A systematic review 前交叉韧带重建和康复治疗与保守治疗相比,在降低前交叉韧带损伤后创伤性骨关节炎发病率方面的疗效:系统综述
Q3 Health Professions Pub Date : 2024-07-26 DOI: 10.15619/nzjp.v52i2.339
Catherine McIntosh, Daniel O'Brien, Duncan Reid, Richard Ellis
Anterior cruciate ligament (ACL) injury is a risk factor for developing post-traumatic osteoarthritis (PTOA). The burden of ACL injuries and PTOA is considerable and predicted to increase if there is no change in their management. The efficacy of different ACL rehabilitation interventions in reducing the incidence of PTOA is unknown. This systematic review aimed to identify, synthesise, and critique research findings that evaluated the effectiveness of anterior cruciate ligament reconstruction (ACLR) plus rehabilitation compared to rehabilitation alone on the incidence of PTOA following ACL injury. A quality critique of the selected studies was undertaken using a modified Downs and Black appraisal tool. Data were extracted and analysed to answer the research question: What is the effect of ACL reconstruction and rehabilitation compared to conservative management on the incidence of PTOA after ACL injury? Six good-quality articles were retained for final review. Five studies compared the effect of surgical and non-surgical management of ACL injuries on developing PTOA. One study investigated the impact of different ACL rehabilitation protocols on the development of PTOA. The incidence of PTOA following ACL injury was comparable regardless of the surgical or non-surgical intervention and rehabilitation compared in each study. Further high-quality studies are needed to inform ACL injury management to reduce the impact of PTOA following ACL injury.
前十字韧带(ACL)损伤是罹患创伤后骨关节炎(PTOA)的风险因素之一。前交叉韧带损伤和创伤后骨关节炎的负担相当沉重,如果不改变其治疗方法,预计其负担还会增加。不同的前交叉韧带康复干预措施对降低 PTOA 发病率的效果尚不清楚。本系统性综述旨在对评估前交叉韧带损伤后前交叉韧带重建(ACLR)加康复治疗与单纯康复治疗对 PTOA 发生率的有效性的研究结果进行识别、综合和评论。我们使用改进的唐斯和布莱克评估工具对所选研究进行了质量评估。通过提取和分析数据来回答研究问题:与保守治疗相比,前交叉韧带重建和康复治疗对前交叉韧带损伤后 PTOA 的发生率有何影响?最终审查保留了六篇质量较高的文章。五项研究比较了前交叉韧带损伤的手术治疗和非手术治疗对发生 PTOA 的影响。一项研究调查了不同的前交叉韧带康复方案对 PTOA 发生的影响。在每项研究中,无论采用哪种手术或非手术疗法以及康复方案,前交叉韧带损伤后 PTOA 的发生率都相当。我们需要进一步开展高质量的研究,为前交叉韧带损伤管理提供信息,以减少前交叉韧带损伤后 PTOA 的影响。
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引用次数: 0
The relevance of research in clinical practice 研究与临床实践的相关性
Q3 Health Professions Pub Date : 2024-07-26 DOI: 10.15619/nzjp.v52i2.425
Kirsten Davie
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引用次数: 0
Whiplash-associated disorders: A case report 鞭状相关疾病:病例报告
Q3 Health Professions Pub Date : 2024-07-26 DOI: 10.15619/nzjp.v52i2.376
Grace Battal, Berthe Hanna-Boutros
Approximately 50% of people who suffer from whiplash enter the chronic phase of this condition and develop persistent symptoms known as chronic whiplash-associated disorders (WAD). This case study aims to contribute to the understanding of rehabilitation programmes combining cervical exercises and proprioceptive training for managing such conditions, as the literature supporting their significance is inconclusive. A 29-year-old female with chronic WAD was evaluated using goniometry, the visual analog scale (VAS), and the neck disability index (NDI). She displayed reduced neck mobility, local neck pain associated with cervicogenic headache, and neck-related disability. The intervention lasted 6 weeks, involving two 40 min weekly sessions. The exercise programme incorporated cervical spine-specific exercises, including range of motion, postural endurance, and muscle strengthening, as well as sensorimotor exercises targeting kinaesthetic sense, eye movement control, and eye-head coordination. The outcome measures reflected the resolution of symptoms and physical impairments. The patient experienced significant improvements in cervical mobility, as she regained a full range of movement in all planes. The patient also demonstrated amelioration in both pain and cervical function states. The VAS score dropped from 6/10 to 2/10; likewise, the NDI score decreased from 58% to 22% at the end of the treatment. Our observations suggest that a rehabilitation programme retraining both the cervical musculature and sensorimotor control may be effective in reducing pain and disability in people with chronic WAD. Further research is required to determine the optimal exercise programme for managing symptoms chronicity in people with WAD.
约有 50%的鞭打伤患者会进入慢性期,出现持续性症状,即慢性鞭打相关障碍(WAD)。本病例研究旨在帮助人们了解结合颈椎锻炼和本体感觉训练的康复计划对控制此类病症的意义,因为支持其意义的文献尚无定论。研究人员使用动态关节角度计、视觉模拟量表(VAS)和颈部残疾指数(NDI)对一名患有慢性颈椎病的 29 岁女性进行了评估。她的颈部活动度降低,局部颈部疼痛伴有颈源性头痛,并伴有颈部相关残疾。干预持续了 6 周,每周两次,每次 40 分钟。运动计划包括颈椎特定运动,包括活动范围、姿势耐力和肌肉强化,以及针对运动感觉、眼球运动控制和眼头协调的感觉运动练习。疗效指标反映了症状和身体损伤的缓解情况。患者的颈椎活动能力有了明显改善,所有平面的活动范围都得到了恢复。患者的疼痛和颈椎功能状态也有所改善。VAS评分从6/10降至2/10;同样,在治疗结束时,NDI评分从58%降至22%。我们的观察结果表明,对颈部肌肉和感觉运动控制进行再训练的康复计划可以有效减轻慢性腰椎间盘突出症患者的疼痛和残疾程度。要确定管理 WAD 患者慢性症状的最佳运动计划,还需要进一步的研究。
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引用次数: 0
Aotearoa New Zealand physiotherapists’ perspectives of potential expanded roles for sports-related concussion management: A qualitative study 新西兰奥特亚罗瓦物理治疗师对运动相关脑震荡管理的潜在扩展角色的看法:定性研究
Q3 Health Professions Pub Date : 2024-07-26 DOI: 10.15619/nzjp.v52i2.390
Mya Dalton, Olivia Galea, Rebecca Blyth, Duncan Reid, Dusty Quinn, Jason Chua, G. Sole
Concussions (mild traumatic head injury) have received increasing attention in clinical practice, research, and the public press. A range of healthcare providers engage with patients presenting with concussion, and physiotherapists are often at the front line of these consultations, especially on the sports field. We explored physiotherapists’ perspectives of their scope of practice and actual clinical practice within the sports-related concussion diagnosis and return-to-sport context. A qualitative approach with interviews and focus groups was used, including 18 physiotherapists. Three themes were derived: (a) delayed access to concussiontrained general practitioners; (b) navigating concussion care in a strained healthcare system; and (c) proposed expanded role for physiotherapists. Delayed patient access to medical doctors often delayed a formal concussion diagnosis, initiation of specific concussion care, or medical sports clearance. Yet the participants were regularly identifying and managing concussions, and most felt confident to do so. Some participants, particularly those working with high-performance athletes or in multidisciplinary teams, suggested that concussion diagnosis and clearance for return to work or play should remain the medical doctors’ responsibilities. Yet participants working at community level suggested that, with relevant training and mentored experience, diagnosis, triaging, and clearance for sport could be within their scope of practice.
脑震荡(轻度头部外伤)在临床实践、研究和公共媒体中受到越来越多的关注。各种医疗服务提供者都会接触到脑震荡患者,而物理治疗师往往处于这些咨询的第一线,尤其是在运动场上。我们探讨了物理治疗师对其执业范围的看法以及在运动相关脑震荡诊断和重返运动场背景下的实际临床实践。我们采用了定性方法,对 18 名物理治疗师进行了访谈和焦点小组讨论。得出了三个主题:(a) 患者迟迟得不到受过脑震荡培训的全科医生的诊治;(b) 在紧张的医疗保健系统中进行脑震荡护理;(c) 建议扩大物理治疗师的作用。患者迟迟得不到医生的诊治,往往延误了脑震荡的正式诊断、特定脑震荡护理的启动或运动医疗许可。然而,参与者定期对脑震荡进行识别和处理,而且大多数人对这样做充满信心。一些参与者,特别是那些为高水平运动员或多学科团队工作的参与者建议,脑震荡诊断和恢复工作或比赛的许可仍应由医生负责。然而,在社区层面工作的与会者则认为,如果接受过相关培训并获得指导经验,诊断、分流和批准重返运动场都属于他们的工作范围。
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引用次数: 0
Patient expectations of benefit from physiotherapy and relationship to self-reported outcomes: A pilot study 患者对物理治疗益处的期望及与自我报告结果的关系:试点研究
Q3 Health Professions Pub Date : 2024-07-26 DOI: 10.15619/nzjp.v52i2.361
Dustin Barrett, Jennifer Pearcy, Michael Bourassa, C. Wassinger
Research demonstrates that patient expectations have an influence on physiotherapy outcomes, but little is known regarding expectation changes over time. The primary objective of this pragmatic prospective cohort pilot study was to correlate patient expectations at baseline and after 2 weeks of physiotherapy to self-reported patient outcomes at discharge from physiotherapy treatment. Eligible adult patients with a variety of musculoskeletal disorders reported recovery expectations at initial evaluation and after 2 weeks of treatment. Correlations between expectations and self-reported outcome measures were calculated. Seventeen participants completed this study, and made clinically important improvements over the course of care. Expectations at baseline and 2-week time points generally indicated that participants expect to have a positive outcome from physiotherapy treatment. Participants’ baseline expectations were not significantly correlated to outcome measures or clinically important changes. Yet 2-week expectations were significantly correlated with outcomes and the likelihood of achieving clinically important changes in outcome measures. This relationship may be stronger at 2 weeks compared to baseline. Clinicians might consider repeated measuring of patient recovery expectations across the plan of care to best meet patient needs.
研究表明,患者的期望会影响物理治疗的效果,但人们对期望随时间的变化知之甚少。这项务实的前瞻性队列试点研究的主要目的是将患者在物理治疗基线和两周后的期望与物理治疗出院时患者自我报告的治疗效果相关联。符合条件的患有各种肌肉骨骼疾病的成年患者在初次评估和治疗 2 周后报告了康复期望。研究还计算了期望值与自我报告结果之间的相关性。17 名参与者完成了这项研究,并在治疗过程中取得了重要的临床改善。在基线和两周时间点的期望值普遍表明,参与者期望从物理治疗中获得积极的结果。参与者的基线期望与结果测量或临床重要变化无明显相关性。然而,两周后的期望值却与治疗结果以及在治疗结果中实现重要临床变化的可能性有明显的相关性。与基线相比,这种关系在两周时可能更强。临床医生可以考虑在整个护理计划中反复测量患者的康复期望值,以最大限度地满足患者的需求。
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引用次数: 0
Physiotherapy students' perspectives of a blended learning approach through the COVID-19 pandemic years 物理治疗专业学生通过 COVID-19 大流行年对混合式学习方法的看法
Q3 Health Professions Pub Date : 2024-03-28 DOI: 10.15619/nzjp.v52i1.343
Suzanne Belcher, Peter Larmer, Rory Christopherson, Kesava Kovanur Sampath
The Waikato Institute of Technology launched an innovative approach in 2019 to deliver a Bachelor of Physiotherapy degree. The programme utilised a blended-block learning andragogy of face-to-face (block-week) and online learning. At the end of the first 4-year cycle, it seemed pertinent to understand the students’ perspective of this approach, while recognising possible effects of the COVID-19 pandemic. An online questionnaire was distributed to a sample of students (n = 70), with 44% completing the survey. Preference to continue with block-week learning was split: 32.2% of students wished to continue with the current approach, 32.2% preferred to discontinue and return to traditional campus teaching, and 35.6% were unsure. Those students who preferred to discontinue predominantly originated or moved to the Hamilton region for study. Students who preferred block-blended learning were often from a population that the programme was meant to serve, living in rural areas and/or having significant family/community responsibilities, meaning they were unable to move to the institute and would struggle to access the course in any other manner. To reduce fatigue and improve satisfaction, students also suggested mixing content delivery every week, engaging in 2–3 days of face-to-face sessions and 2 3 days online, moving away from block-learning yet retaining blended-learning. Most students believed the course was well positioned to manage the effects of COVID-19; however, they recognised practical skills learning and access to clinical placement experience was reduced. Future research could focus on exploring the benefits and barriers of online learning developed for physiotherapy-specific content.
怀卡托理工学院于 2019 年推出了一种创新方法,以提供物理治疗学士学位。该课程采用面授(街区-周)和在线学习的混合街区学习法。在第一个四年周期结束时,似乎有必要了解学生对这种方法的看法,同时认识到 COVID-19 大流行可能造成的影响。我们向抽样学生(n = 70)发放了一份在线问卷,44% 的学生完成了调查。学生们对继续进行整周学习的意愿各不相同:32.2%的学生希望继续采用目前的教学方法,32.2%的学生希望停止这种方法,回到传统的校园教学,35.6%的学生不确定。倾向于停止学习的学生主要来自汉密尔顿地区或搬到汉密尔顿地区学习。倾向于分块混合式学习的学生通常来自该课程的服务对象,他们生活在农村地区和/或承担着重要的家庭/社区责任,这意味着他们无法搬到学院,也很难通过其他方式学习该课程。为了减少疲劳感和提高满意度,学生们还建议每周混合授课内容,进行 2-3 天的面授和 2-3 天的在线学习,摒弃模块式学习,但保留混合式学习。大多数学生认为,该课程能够很好地控制 COVID-19 的影响;但他们认识到,实践技能学习和临床实习经验的机会减少了。未来的研究可以重点探索针对物理治疗特定内容开发的在线学习的益处和障碍。
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引用次数: 0
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New Zealand Journal of Physiotherapy
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