"Six sessions is a drop in the ocean": an exploratory study of neurological physiotherapy in idiopathic and inherited ataxias
"Six sessions is a drop in the ocean": an exploratory study of neurological physiotherapy in idiopathic and inherited ataxias
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DOI：
10.1016/j.physio.2013.02.001
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发表时间：
2013-12-01
期刊：
影响因子：
3.3
通讯作者：
Ealing, John
中科院分区：
文献类型：
--
作者：
Daker-White, Gavin;Greenfield, Julie;Ealing, John
目的 一项探索性研究，旨在检验针对进行性共济失调患者的专业神经物理治疗服务的提供和利用。设计定性研究，涉及对物理治疗师和患者进行半结构化访谈的主题分析。在英国大曼彻斯特设置共济失调患者和专业神经康复物理治疗师。参与者包括 38 名共济失调患者和 8 名在 NHS 和私人机构的学术、医院和社区服务工作的神经物理治疗师设置。招募在与患者群体合作方面经验丰富的物理治疗师是一项挑战。干预措施在物理治疗师的工作场所或患者自己的家中进行一小时的横断面半结构化访谈。结果在 38 名共济失调患者中，有 25 名 (66%) 经历过神经物理治疗。分析中出现的首要主题是“发挥作用”、参与度和服务提供。两个样本中的大多数都认为，服务的组织应提供长期治疗和支持，而不仅仅是短期护理方案，然后提供家庭锻炼计划。服务参与度与患者的期望、依从性和对结果的看法相关。数据集中最主要的代码被主题“有所作为”所概括，其中进一步包括对如何在逐渐衰退的背景下衡量感知的临床改善（如患者所经历的）的担忧。结论研究结果提出了一种理想化的服务提供模式，涉及整体的、开放的服务，包括改善证据基础的研究工作。需要特别注意衡量治疗后的改善情况。 (C) 2013 年特许物理治疗学会。由爱思唯尔有限公司出版。保留所有权利。
Objective An exploratory study to examine specialist neurological physiotherapy service provision and utilisation for people with progressive ataxia.Design Qualitative study involving thematic analysis of accounts in semi-structured interviews with physiotherapists and patients.Setting People with ataxia and specialist neuro-rehabilitation physiotherapists in Greater Manchester, UK.Participants 38 people with ataxia and 8 neurological-physiotherapists working in academic and hospital and community-based services in NHS and private settings. Recruiting physiotherapists experienced in working with the patient group was a challenge.Interventions One hour cross-sectional semi-structured interview at physiotherapists' workplaces or in patients' own homes.Results Neurological physiotherapy was experienced by 25 (66%) of the 38 people with ataxia. The overarching themes emerging from the analysis were 'making a difference,' engagement and service provision. A majority of both samples felt that services should be organised so as to provide longer term therapy and support that goes beyond short care packages followed by provision of home exercise programme Engagement with services was linked to patient expectations, adherence and perception of outcomes. The most predominant codes in the data set were encapsulated by the theme 'making a difference,' which further included concerns about how to measure perceived clinical improvement (as experienced by patients) in the context of progressive decline.Conclusions The findings suggest a model of idealised service provision involving a holistic, open-access service including research efforts to improve the evidence base. Special attention needs to be paid to measuring improvements following therapy. (C) 2013 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.