物理治疗师在判断患者预后时会考虑哪些因素?混合方法研究。

IF 1.5 Q3 RHEUMATOLOGY
Musculoskeletal Care Pub Date : 2023-12-01 Epub Date: 2023-09-15 DOI:10.1002/msc.1823
Matthew P Smith, Brad Tracy, Jason Soncrant, Jodi L Young, Daniel I Rhon, Chad E Cook
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引用次数: 0

摘要

介绍:预后为治疗过程中的预期进展和预期结果提供了宝贵的信息。尽管众所周知,物理治疗师能够准确预测预后,但在临床实践中利用了哪些因素却不得而知:本研究旨在确定影响理疗师临床推理过程的预后领域和因素:混合方法设计,肯定物理治疗师的预后能力,并对物理治疗师考虑的预后因素进行定性探索:29名物理治疗师参与了本研究。参与者接受了半结构化定性访谈,并对访谈内容进行了编码,以构建预后框架。此外,还使用了去标识化的患者数据来确定物理治疗师形成预后的能力。线性回归用于确定初始预后评分是否与出院时的功能相关:结果:与出院时的功能有明显关系(P = 结论:我们的研究结果支持 PT 与出院时功能之间的关系:我们的研究结果支持肌肉骨骼疼痛患者的 PT 预后与患者预后之间的关系。此外,康复治疗师在评估过程中用于制定预后的领域和因素呈现出一个复杂的生物-心理-社会框架,这表明康复治疗师在制定预后时会考虑多个领域的因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
What factors do physical therapists consider when determining patient prognosis: A mixed methods study.
INTRODUCTION A prognosis provides valuable information to expected progress and anticipated outcome over the course of care. Although it is known that physical therapists can accurately prognose, it is unknown what factors are utilised in clinical practice. OBJECTIVE The purpose of this study was to determine the prognostic domains and factors that influenced a PT's clinical reasoning processes. DESIGN Mixed Methods Design, affirming the prognostic ability of the physical therapists and the qualitative exploration of the prognostic factors considered by physical therapists. METHODS Twenty-nine physical therapists participated in this study. Participants underwent semi-structured qualitative interviews that were coded to populate a prognostic framework. In addition, de-identified patient data was used to determine the ability of the PT to form a prognosis. Linear regression was used to determine if an initial prognostic score was related to function at discharge. RESULTS There were significant relationships (p = <0.05) between the prognosis score and Focus on Therapeutic Outcomes (B = 2.25), Numeric Pain Rating Scale (B = 0.257), and GROC (B = 0.289) upon patient discharge. Qualitative factors were categorised into prognostic domains (prevalence): Mood, Motivation, Pain Behaviours (100%), Disease Severity (93.1%), Health Status (86.2%), Social, Occupation, Environmental (67.0%), and Genetics, Biology, Biomarkers (44.8%). Factors that did not fit established domains were reported and categorised as Other (86.2%). CONCLUSION Our findings support the relationship between PT prognosis of patients with musculoskeletal pain and patient outcomes. In addition, the domains and factors PTs use to formulate prognosis during evaluation present a complex biopsychosocial framework, suggesting that PTs consider factors from multiple domains when forming a prognosis.
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来源期刊
Musculoskeletal Care
Musculoskeletal Care RHEUMATOLOGY-
CiteScore
2.30
自引率
7.70%
发文量
88
期刊介绍: Musculoskeletal Care is a peer-reviewed journal for all health professionals committed to the clinical delivery of high quality care for people with musculoskeletal conditions and providing knowledge to support decision making by professionals, patients and policy makers. This journal publishes papers on original research, applied research, review articles and clinical guidelines. Regular topics include patient education, psychological and social impact, patient experiences of health care, clinical up dates and the effectiveness of therapy.
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