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澳大利亚膝骨关节炎物理治疗的患者体验:一项定性研究。

Patient experiences with physiotherapy for knee osteoarthritis in Australia-a qualitative study.

机构信息

Department of Physiotherapy, University of Melbourne, Melbourne, Victoria, Australia.

Impact Accelerator Unit, School of Medicine, Keele University, Keele, Staffordshire, ST5 5BG, UK.

出版信息

BMJ Open. 2021 Mar 8;11(3):e043689. doi: 10.1136/bmjopen-2020-043689.

Abstract

OBJECTIVE

Physiotherapists commonly provide non-surgical care for people with knee osteoarthritis (OA). It is unknown if patients are receiving high-quality physiotherapy care for their knee OA. This study aimed to explore the experiences of people who had recently received physiotherapy care for their knee OA in Australia and how these experiences aligned with the national Clinical Care Standard for knee OA.

DESIGN

Qualitative study using semistructured individual telephone interviews and thematic analysis, where themes/subthemes were inductively derived. Questions were informed by seven quality statements of the OA of the Knee Clinical Care Standard. Interview data were also deductively analysed according to the Standard.

SETTING

Participants were recruited from around Australia via Facebook and our research volunteer database.

PARTICIPANTS

Interviews were conducted with 24 people with recent experience receiving physiotherapy care for their knee OA. They were required to be aged 45 years or above, had activity-related knee pain and any knee-related morning stiffness lasted no longer than 30 min. Participants were excluded if they had self-reported inflammatory arthritis and/or had undergone knee replacement surgery for the affected knee.

RESULTS

Six themes emerged: (1) presented with a pre-existing OA diagnosis (prior OA care from other health professionals; perception of adequate OA knowledge); (2) wide variation in access and provision of physiotherapy care (referral pathways; funding models; individual vs group sessions); (3) seeking physiotherapy care for pain and functional limitations (knee symptoms; functional problems); (4) physiotherapy management focused on function and exercise (assessment of function; various types of exercises prescribed; surgery, medications and injections are for doctors; adjunctive treatments); (5) professional and personalised care (trust and/or confidence; personalised care) and (6) physiotherapy to postpone or prepare for surgery.

CONCLUSION

Patients' experiences with receiving physiotherapy care for their knee OA were partly aligned with the standard, particularly regarding comprehensive assessment, self-management, and exercise.

摘要

目的

物理治疗师通常为膝骨关节炎(OA)患者提供非手术治疗。目前尚不清楚患者是否接受了针对膝 OA 的高质量物理治疗护理。本研究旨在探讨澳大利亚最近接受过膝骨关节炎物理治疗护理的患者的体验,以及这些体验如何与国家膝骨关节炎临床护理标准相吻合。

设计

使用半结构式个人电话访谈和主题分析的定性研究,主题/子主题是通过七个膝骨关节炎临床护理标准的质量声明来得出的。访谈问题还根据该标准进行了演绎分析。

设置

通过 Facebook 和我们的研究志愿者数据库,从澳大利亚各地招募参与者。

参与者

对最近接受过膝骨关节炎物理治疗护理的 24 名患者进行了访谈。他们必须年满 45 岁或以上,有与活动相关的膝关节疼痛,任何与膝关节相关的晨僵持续时间不超过 30 分钟。如果参与者自述患有炎症性关节炎和/或已对受影响的膝关节进行了膝关节置换手术,则将其排除在外。

结果

出现了六个主题:(1)存在先前的 OA 诊断(先前由其他健康专业人员提供的 OA 护理;对 OA 知识的充分认识);(2)物理治疗护理的可及性和提供存在广泛差异(转诊途径;资金模式;个体与小组治疗);(3)因疼痛和功能受限寻求物理治疗护理(膝关节症状;功能问题);(4)物理治疗管理侧重于功能和锻炼(功能评估;开出处方的各种类型的锻炼;手术、药物和注射是医生的事;辅助治疗);(5)专业和个性化的护理(信任和/或信心;个性化护理);(6)为推迟或准备手术而进行的物理治疗。

结论

患者接受膝骨关节炎物理治疗护理的体验在一定程度上与标准相符,特别是在全面评估、自我管理和锻炼方面。

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