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Factors Influencing Physical Therapists’ Rehabilitation Prescription in the ICU: Semi-structured Interviews with Qualitative Analysis 影响物理治疗师在重症监护病房开具康复处方的因素:半结构式访谈与定性分析
IF 1 4区 医学 Q4 REHABILITATION Pub Date : 2023-12-19 DOI: 10.3138/ptc-2023-0017
Stephanie L. Hiser, Bhavna Seth, M. Hosey, Dale M. Needham, M. Eakin
Despite a plethora of studies on early rehabilitation, specific guidelines for rehabilitation prescription parameters are lacking. The objective of this study was to evaluate how physical therapists determine rehabilitation parameters such as initiation, frequency, intensity, duration, and type of interventions for patients in the ICU. Semi-structured interviews were conducted between April and August of 2021 using video conferencing software following a written interview guide. Purposive sampling was used among interested physical therapists to select those who work across a variety of ICU types with a range of years of ICU experience. We used thematic analysis to identify emerging themes using an inductive approach. We interviewed 30 physical therapists in the USA with 14 (47%) and 16 (53%) having ≤5 years and >5 years of ICU clinical experience, respectively. Nine factors were identified as impacting all rehabilitation prescription parameters (e.g., medical appropriateness, diagnosis/prognosis, and alertness/sedation). For decisions about each parameter there were a set of factors identified: five for initiation (e.g., indication for physical therapy; ventilator settings/oxygen), four for frequency (e.g., baseline function; prior therapy session), three for intensity (e.g., patient appearance and subjective response), nine for duration (e.g., session preparation; quality of performance), and eight for type of intervention (e.g., progressive mobility; patient goals). Interviews examining rehabilitation parameters, revealed that physical therapists consider each of these simultaneously when making decisions about rehabilitation prescription. Furthermore, physical therapists appear to modify to the intervention not only based on patient progress, but by other external factors related to working in an ICU environment (e.g., equipment availability, interruptions for other medical procedures).
尽管对早期康复进行了大量研究,但仍缺乏康复处方参数的具体指导。本研究旨在评估物理治疗师如何确定重症监护病房患者的康复参数,如干预的开始、频率、强度、持续时间和类型。在 2021 年 4 月至 8 月期间,根据书面访谈指南,使用视频会议软件进行了半结构化访谈。我们在感兴趣的物理治疗师中进行了有目的的抽样调查,以选择那些在各种类型的重症监护室工作过、具有不同年限重症监护室工作经验的物理治疗师。我们采用归纳法进行主题分析,以确定新出现的主题。我们在美国采访了 30 名物理治疗师,其中 14 人(47%)和 16 人(53%)分别拥有≤5 年和 >5 年的 ICU 临床经验。研究发现,有九个因素会影响所有康复处方参数(如医疗适宜性、诊断/预后和警觉/镇定)。在决定每项参数时,还确定了一系列因素:五项是启动因素(如物理治疗的指征;呼吸机设置/氧气),四项是频率因素(如基线功能;之前的治疗疗程),三项是强度因素(如患者的外观和主观反应),九项是持续时间因素(如疗程准备;表现质量),八项是干预类型因素(如渐进移动;患者目标)。通过对康复参数的访谈发现,物理治疗师在决定康复处方时,会同时考虑这些参数。此外,物理治疗师似乎不仅会根据患者的进展情况,还会根据与在重症监护室环境中工作有关的其他外部因素(如设备的可用性、其他医疗程序的中断)来修改干预措施。
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引用次数: 0
Entry-to-Practice Business and Practice Management Competencies: A Qualitative Systematic Review to Inform Canadian Physiotherapy Curricula 入门业务和实践管理能力:为加拿大物理治疗课程提供信息的定性系统回顾
IF 1 4区 医学 Q4 REHABILITATION Pub Date : 2023-12-12 DOI: 10.3138/ptc-2022-0051
Corey Coward, Josh Hunter, Sandra M. Halliday, Brendy Jeffers, Diana Hopkins-Rosseel
There is increasing demand for business skills among healthcare professionals. The aim of this qualitative systematic review was to identify and summarize existing business and practice management (BPM) competencies for rehabilitation university graduates with the intention to inform curricula. The key electronic databases searched include ABI/INFORM Global, CINAHL, Education Source, Embase, and Medline. The initial search was performed in December 2018 and updated June 2021 with the following inclusion criteria: articles addressing BMP competencies in university-level rehabilitation programs in developed countries. To ensure professional position statements and standards documents were captured, this grey literature was also included. Resources were extracted using EndNote and two reviewers independently screened and appraised the resources using the AACODS Checklist. Nine resources met the inclusion criteria and were incorporated in the qualitative synthesis. Quality-assessment scores ranged from 4 to 6 out of 6 on the AACODS Checklist. Several practice management competencies were consistent across multiple rehabilitation professions. However, business competencies were inconsistent with “marketing” and the “ability to develop a business plan” arising sporadically across Occupational Therapy and Physiotherapy competency profiles, as well as individual audiology courses. There is insufficient evidence to suggest that a consensus exists for BPM competencies for rehabilitation university graduates in Canada. The aggregate list of 64 competencies compiled can be used to inform further research.
医疗保健专业人员对业务技能的需求与日俱增。本定性系统综述旨在确定和总结康复专业大学毕业生现有的商业和实践管理(BPM)能力,为课程设置提供参考。检索的主要电子数据库包括 ABI/INFORM Global、CINAHL、Education Source、Embase 和 Medline。初次检索于 2018 年 12 月进行,并于 2021 年 6 月更新,纳入标准如下:涉及发达国家大学康复专业 BMP 能力的文章。为确保收录专业立场声明和标准文件,还收录了灰色文献。使用 EndNote 提取资源,并由两名审稿人使用 AACODS 核对表对资源进行独立筛选和评估。有 9 篇资料符合纳入标准,并被纳入定性综述。AACODS 检查表的质量评估分数从 4 分到 6 分不等(满分 6 分)。多个康复专业的实践管理能力是一致的。然而,业务能力却不一致,"市场营销 "和 "制定业务计划的能力 "在职业疗法和物理疗法的能力简介以及听力学的个别课程中零星出现。没有足够的证据表明加拿大康复专业大学毕业生的商业管理能力已达成共识。所汇编的 64 项能力的总清单可为进一步的研究提供信息。
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引用次数: 0
Impact of Income on Physical Concerns, Help Seeking, and Unmet Needs of Adult Cancer Survivors. 收入对成年癌症幸存者身体问题、寻求帮助和未满足需求的影响。
IF 1 4区 医学 Q4 REHABILITATION Pub Date : 2023-11-27 eCollection Date: 2023-11-01 DOI: 10.3138/ptc-2021-0084
Irene Nicoli, Gina Lockwood, Lauren Fitch, Christopher J Longo, Margaret I Fitch

Purpose: Cancer treatment can have consequences for individuals which may have profound impact on daily living. Accessing assistance can be problematic. This study explores associations between income and concerns, help-seeking, and unmet needs related to physical changes following cancer treatment.

Method: A national survey was conducted with cancer survivors about experiences with follow-up care one to three years after treatment. We report a trend analysis describing associations between income and cancer survivors' concerns, help-seeking, and unmet needs related to physical changes after treatment.

Results: In total 5,283 cancer survivors between 18 and 64 years responded, of which 4,264 (80.7%) indicated annual household income. The majority of respondents were survivors of breast (34.4%), colorectal (15.0%), and prostate (14.0%) cancers. Over 90% wrote about experiencing physical changes following cancer treatment. Survivors with low annual household incomes of less than $25,000 (CAN) reported the highest levels of concern about multiple physical changes and were more likely to seek help to address them.

Conclusions: Cancer survivors can experience various physical challenges and unmet needs following cancer treatment and difficulty obtaining relevant help across all income levels. Those with low income are more severely affected. Financial assessment and tailored follow-up are recommended.

目的:癌症治疗可能对个人的日常生活产生深远的影响。获得援助可能会有问题。本研究探讨了收入与癌症治疗后身体变化相关的担忧、寻求帮助和未满足需求之间的关系。方法:对癌症幸存者进行一项全国性调查,了解治疗后1至3年随访护理的经历。我们报告了一项趋势分析,描述了收入与癌症幸存者的担忧、寻求帮助和治疗后未满足的身体变化相关需求之间的关系。结果:共有5283名年龄在18至64岁之间的癌症幸存者回应,其中4264人(80.7%)表示家庭年收入。大多数受访者是乳腺癌(34.4%)、结直肠癌(15.0%)和前列腺癌(14.0%)的幸存者。超过90%的人写下了癌症治疗后的身体变化。家庭年收入低于25,000美元(CAN)的幸存者对多种身体变化的担忧程度最高,并且更有可能寻求帮助来解决这些问题。结论:癌症幸存者在接受癌症治疗后可能会遇到各种身体挑战和未满足的需求,并且难以获得相关帮助。低收入人群受到的影响更严重。建议进行财务评估和量身定制的后续行动。
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引用次数: 1
Clinician's Commentary on Madara et al.1. 临床医师对Madara等人的评论。
IF 1 4区 医学 Q4 REHABILITATION Pub Date : 2023-11-27 eCollection Date: 2023-11-01 DOI: 10.3138/ptc-2020-0141-cc
Monica R Maly
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引用次数: 0
Clinician's Commentary on Nakamura et al.1. 临床医师对Nakamura等人的评论。
IF 0.9 4区 医学 Q4 REHABILITATION Pub Date : 2023-11-27 eCollection Date: 2023-11-01 DOI: 10.3138/ptc-2021-0090-cc
Greg Alcock
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引用次数: 0
Clinician Commentary on Brunne et al.1. Brunne等人的临床评论。
IF 0.9 4区 医学 Q4 REHABILITATION Pub Date : 2023-11-27 eCollection Date: 2023-11-01 DOI: 10.3138/ptc-2021-0097-cc
Erin Miller
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引用次数: 0
Clinician's Commentary on Nicoll et al.1. 临床医师对Nicoll等人的评论。
IF 0.9 4区 医学 Q4 REHABILITATION Pub Date : 2023-11-27 eCollection Date: 2023-11-01 DOI: 10.3138/ptc-2021-0084-cc
Holly Edward, Jenna Smith-Turchyn
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引用次数: 0
Clinician's Commentary on Strike et al. 临床医生对Strike等人的评论。
IF 0.9 4区 医学 Q4 REHABILITATION Pub Date : 2023-11-27 eCollection Date: 2023-11-01 DOI: 10.3138/ptc-2021-0079-cc
Vitor Hugo Azevedo, Ana Oliveira
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引用次数: 0
What Does Cochrane Say About Rehabilitation for Cancer? 关于癌症康复,科克伦说了些什么?
IF 1 4区 医学 Q4 REHABILITATION Pub Date : 2023-11-27 eCollection Date: 2023-11-01 DOI: 10.3138/ptc-75.4-cochrane
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引用次数: 0
A Non-Pharmacological Cough Therapy for People with Interstitial Lung Diseases: A Case Report. 肺间质性疾病的非药物咳嗽治疗一例报告。
IF 1 4区 医学 Q4 REHABILITATION Pub Date : 2023-11-27 eCollection Date: 2023-11-01 DOI: 10.3138/ptc-2021-0081
Sabrina Dasouki, Shirley Quach, Renata Mancopes, Sarah Chamberlain Mitchell, Roger Goldstein, Dina Brooks, Ana Oliveira

Purpose: To explore the feasibility of a non-pharmacological cough control therapy (CCT) customized for a client with interstitial lung disease (ILD).

Client description: An 83-year-old female with hypersensitivity pneumonitis, and chronic cough for 18 years treated previously with pharmacological treatment for the underlying lung disease and gastroesophageal reflux disease, as well as lozenges and breathing and relaxation strategies.

Intervention: Four cough education and self-management sessions (45-60 minutes each) facilitated by a physiotherapist and speech-language pathologist via videoconference were conducted. Session topics included mechanisms of cough in ILD, breathing and larynx role in cough control, trigger identification, cough suppression and control strategies, and psychosocial support towards behaviour change using motivational interviewing.

Measures and outcome: The following assessments were conducted prior to and one week after the intervention: semi-structured interviews, Leicester Cough Questionnaire, King's Brief Interstitial Lung Disease questionnaire, Functional Assessment of Chronic Illness Therapy Fatigue Scale, modified Borg Scale for severity and intensity of cough, and the Global Rating of Change Questionnaire.

Implications: Implementing the CCT was feasible. The client reported increased perceived cough control, a reduction in exhaustion from coughing bouts, and a better understanding of the mechanisms behind cough management and suppression. Improvements were also observed in cough-related quality of life, severity, and intensity.

目的:探讨一种针对间质性肺疾病(ILD)患者的非药物咳嗽控制疗法(CCT)的可行性。患者描述:一名83岁女性,患有过敏性肺炎,慢性咳嗽18年,此前曾接受过潜在肺部疾病和胃食管反流病的药物治疗,以及含片和呼吸放松策略。干预措施:由物理治疗师和语言病理学家通过视频会议进行四次咳嗽教育和自我管理会议(每次45-60分钟)。会议主题包括ILD的咳嗽机制,呼吸和喉部在咳嗽控制中的作用,触发识别,咳嗽抑制和控制策略,以及使用动机访谈对行为改变的社会心理支持。测量方法和结果:在干预前和干预后一周进行以下评估:半结构化访谈、莱斯特咳嗽问卷、King's简短间质性肺病问卷、慢性疾病治疗功能评估疲劳量表、改进的Borg咳嗽严重程度和强度量表,以及全球变化评级问卷。意义:实施有条件现金转移支付是可行的。患者报告咳嗽控制感增强,咳嗽疲劳减少,对咳嗽控制和抑制机制有了更好的理解。咳嗽相关的生活质量、严重程度和强度也有所改善。
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引用次数: 1
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Physiotherapy Canada
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