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J PHYSIOTHER:理疗师为膝骨关节炎患者提供的治疗经验是什么?符合国家标准吗?

2021-10-11 MedSci原创 MedSci原创

理疗师为膝骨关节炎患者提供护理的经验是什么?这些经验如何与国家临床护理标准相一致?

膝关节骨关节炎(OA)是世界范围内关节疼痛和残疾的主要病因,也是膝关节置换手术的常见原因。鉴于OA无法治愈,自我管理(运动和体力活动)是指南推荐的核心管理策略,理疗师是则是重要的康复护理提供者。与所有医疗专业人员一样,理疗师有责任确保他们提供的OA护理是安全并符合最佳实践的。

那么,理疗师为膝骨关节炎患者提供护理的经验是什么?这些经验如何与国家临床护理标准相一致?

研究者招募了22名澳大利亚物理治疗师(平均年龄34岁,50%为女性),具有护理膝骨关节炎患者的经验,并对这些理疗师的治疗内容和模式进行了整理。

理疗师基本资料

研究结果反应了五个方面的问题:首先,物理治疗师专注于生物医学评估,很少考虑心理社会因素。他们管理膝关节骨关节炎的力学方面,旨在恢复功能能力。其次,物理治疗师认为他们的角色主要是通过短期间歇护理提供目标导向的个性化锻炼。膝关节手术被认为是最后的选择,但物理治疗师为决定手术的患者做好准备。第三,理疗师面对的临床挑战包括患者共病、患者依从性不理想以及患者对快速修复的渴望。第四:物理治疗师描述了他们在成像、体重管理和手法治疗方面所知与所做之间的不匹配。第五:物理治疗师认为减肥、药物治疗和手术建议超出了他们的专业职责范围。

总的来说,据物理治疗师报告,为膝骨关节炎患者提供护理的经验基本符合质量护理标准,通过增加对护理的心理社会方面的关注,以及更主动地提供有关减肥、止痛药和膝关节手术的建议和/或转诊,可以进一步改善护理效果,且在描述常见骨关节炎药物和手术干预的潜在好处和危害时,物理治疗师也能确保他们的患者完全了解他们的所有治疗方案。

参考文献:Plt A , Klb A , Bjl A , et al. Physiotherapists may improve management of knee osteoarthritis through greater psychosocial focus, being proactive with advice, and offering longer-term reviews: a qualitative study[J]. Journal of Physiotherapy, 2021, 66( 4):256-265.

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    2022-08-13 lisa438
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    2021-10-13 lmm397
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