Barriers to treatment adherence in physiotherapy outpatient clinics: a systematic review.
Barriers to treatment adherence in physiotherapy outpatient clinics: a systematic review.
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DOI：
10.1016/j.math.2009.12.004
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发表时间：
2010-06
期刊：
影响因子：
--
通讯作者：
Gardiner, Eric
中科院分区：
文献类型：
--
作者：
Jack, Kirsten;McLean, Sionnadh Mairi;Moffett, Jennifer Klaber;Gardiner, Eric
治疗依从性差可能会对结果和医疗费用产生负面影响。然而，人们对物理治疗中治疗依从性的障碍知之甚少。本系统评价的目的是确定通常在肌肉骨骼物理治疗门诊接受治疗的患者的治疗依从性障碍，并提出减少其影响的策略。该综述包括二十项高质量研究，调查肌肉骨骼人群坚持治疗的障碍。有强有力的证据表明，治疗依从性差与基线或前几周身体活动水平低、治疗中运动依从性低、自我效能感低、抑郁、焦虑、无助、社会支持/活动差、感知到的运动障碍数量较多以及运动期间疼痛程度增加有关。考虑克服这些障碍并提高依从性的策略。我们发现许多因素的证据有限，需要进一步的高质量研究来调查这些潜在障碍的预测有效性。许多现有研究都集中在患者因素上，需要进行更多研究来调查卫生专业人员或卫生组织引入的障碍，因为这些因素也可能影响患者对治疗的依从性。
Poor adherence to treatment can have negative effects on outcomes and healthcare cost. However, little is known about the barriers to treatment adherence within physiotherapy. The aim of this systematic review was to identify barriers to treatment adherence in patients typically managed in musculoskeletal physiotherapy outpatient settings and suggest strategies for reducing their impact. The review included twenty high quality studies investigating barriers to treatment adherence in musculoskeletal populations. There was strong evidence that poor treatment adherence was associated with low levels of physical activity at baseline or in previous weeks, low in-treatment adherence with exercise, low self-efficacy, depression, anxiety, helplessness, poor social support/activity, greater perceived number of barriers to exercise and increased pain levels during exercise. Strategies to overcome these barriers and improve adherence are considered. We found limited evidence for many factors and further high quality research is required to investigate the predictive validity of these potential barriers. Much of the available research has focussed on patient factors and additional research is required to investigate the barriers introduced by health professionals or health organisations, since these factors are also likely to influence patient adherence with treatment.
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DOI：
10.1017/s0266462300008667
发表时间：
1995-06-01
影响因子：
3.2
作者：
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发表时间：
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期刊：
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作者：
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