在重症监护中，物理治疗主导的强化俯卧位服务的可接受性：一项多学科临床医生的定性研究。

IF 2.6 3区医学 Q2 CRITICAL CARE MEDICINE

Australian Critical Care Pub Date : 2025-01-31 DOI:10.1016/j.aucc.2024.101162

Stacey Haughton BExSci, DPT , Krisha Saravanan BHSc, BPsychHons , Luke A. McDonald BHlthSci, MPhysioPrac , Joleen W. Rose BSci(Hons), BPhysio(Hons) , Sue Berney BPT, PhD , David J. Berlowitz BAppSciPhty, PhD , Thomas C. Rollinson BPhysio(Hons) , Marnie Graco BPhysio(Hons), PhD

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引用次数: 0

摘要

背景：2019冠状病毒病（COVID-19）大流行导致COVID-19相关呼吸衰竭患者数量增加，需要俯卧位。为了减轻重症监护室（ICU）护理和医务人员的压力，实施了一项以物理治疗为主导的强化俯卧位（PhLIP）服务。目的：本研究的目的是从ICU的护士和医生以及提供该服务的物理治疗师的角度探讨philip服务的可接受性。方法：在可接受性理论框架的指导下，采用半结构化访谈法和焦点小组法进行定性评价。参与者包括医生、护士和物理治疗师，他们与飞利浦服务互动或提供飞利浦服务。结果：共进行了19次访谈（8名医生和11名物理治疗师）和4个焦点小组（13名护士）。在贸易便利化协定的8个领域内确定了11个主题。总体而言，飞利浦团队受到高度重视和赞赏（TFA：情感态度）；实现高质量护理和提高ICU效率（TFA：感知有效性）；降低患者和工作人员的风险（TFA：感知安全性和风险）；并赋予参与其中的临床医生权力（TFA：自我效能）。在飞利浦团队工作是身心俱疲的，由于工作人员的重新分配，这项服务给理疗部门带来了压力（TFA：负担）。对物理治疗师领导的俯卧位服务的信任是影响护理和医疗接受度的关键因素。结论：飞利浦团队提供了可接受的服务，提高了COVID-19大流行期间的临床护理和效率。其他icu应考虑是否有可用性、技能和对所选团队的信心，以便在再次需要时实施密集的俯卧定位服务。研究人员使用TFA来探索医疗保健创新的可接受性，也应该考虑接受者对提供干预的人的信任。

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Acceptability of a physiotherapy-led intensive prone positioning service in intensive care: A qualitative study with multidisciplinary clinicians

Background

The coronavirus disease 2019 (COVID-19) pandemic resulted in an increased number of patients with COVID-19–related respiratory failure requiring prone positioning. To reduce pressure on nursing and medical staff in the intensive care unit (ICU), a physiotherapy-led intensive prone positioning (PhLIP) service was implemented.

Objectives

The aim of this study was to explore the acceptability of the PhLIP service from the perspective of nurses and doctors working in the ICU and the physiotherapists who delivered the service.

Methods

A qualitative evaluation was conducted using semistructured interviews and focus groups, guided by the theoretical framework of acceptability (TFA). Participants included doctors, nurses, and physiotherapists who interacted with or delivered the PhLIP service.

Results

A total of 19 interviews (eight doctors and 11 physiotherapists) and four focus groups (13 nurses) were conducted. Eleven themes were identified within the eight domains of the TFA. Overall, the PhLIP team was highly valued and appreciated (TFA: affective attitude); enabled high-quality care and improved ICU efficiency (TFA: perceived effectiveness); reduced risks to patients and staff (TFA: perceived safety and risk); and was empowering for the clinicians involved (TFA: self-efficacy). Being in the PhLIP team was physically and mentally exhausting, and the service put strain on the physiotherapy department due to reallocation of staff (TFA: burden). Having trust in the physiotherapists leading the prone positioning service was a key influence on nursing and medical acceptance of the service.

Conclusion

The PhLIP team delivered an acceptable service that improved clinical care and efficiency during the COVID-19 pandemic. Other ICUs should consider the availability, skills, and confidence in the team selected to implement an intensive prone positioning service, should the need arise again. Researchers using the TFA to explore acceptability of healthcare innovations should also consider the recipients’ trust in those delivering the intervention.

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来源期刊

Australian Critical Care NURSING-NURSING

CiteScore

4.90

自引率

9.10%

发文量

148

审稿时长

>12 weeks

期刊介绍： Australian Critical Care is the official journal of the Australian College of Critical Care Nurses (ACCCN). It is a bi-monthly peer-reviewed journal, providing clinically relevant research, reviews and articles of interest to the critical care community. Australian Critical Care publishes peer-reviewed scholarly papers that report research findings, research-based reviews, discussion papers and commentaries which are of interest to an international readership of critical care practitioners, educators, administrators and researchers. Interprofessional articles are welcomed.