Canadian physiotherapists' views on certification, specialisation, extended role practice, and entry-level training in rheumatology

详细信息    查看全文

• 作者：Linda C Li (1) (2)
  Marie D Westby (1) (3)
  Evelyn Sutton (4) (5)
  Marlene Thompson (6)
  Eric C Sayre (2) (7)
  Lynn Casimiro (8)
  
• 刊名：BMC Health Services Research
• 出版年：2009
• 出版时间：December 2009
• 年：2009
• 卷：9
• 期：1
• 全文大小：214KB
• 参考文献：1. Physiotherapy Scope of Practice Review 2008: Submission to the Health Professions Regulatory Advisory Council. / Ontario Physiotherapy Association and College of Physiotherapists of Ontario. Ontario 2008.
  2. Registration Changes under HPA (Health Professions Act) -HPA legislation will bring new registration terminology and processesEdmonton, Alberta, College of Physical Therapists of Alberta. College Challenges 2008.
  3. Vliet Vlieland TP, Li LC, MacKay C, Badley EM: Does everybody need a team? / J Rheumatol 2006, 33:1897-899.
  4. Lineker SC, Wood H, Badley EM, Stegne L, Wilkins A: / Evaluation of the Primary Therapist Model of Service Delivery as Implemented by The Arthritis Society, Consultation and Rehabilitation Service. Phase 1: Therapist Survey Working Paper 98- edn. Toronto, Ontario: Arthritis Community Research & Evaluation Unit (ACREU) 1998.
  5. Li LC, Davis AM, Lineker S, Coyte PC, Bombardier C: The outcome of patients with rheumatoid arthritis who were referred to received treatment from a primary therapist -A randomized controlled trial. / Arthritis Rheum 2006, 55:42-2. CrossRef
  6. Stokes BA, Helewa A, Lineker SC: Total assessment of rheumatoid polyarthritis–a postgraduate training program for physical and occupational therapists: a 20 year success story. / J Rheumatol 1997, 24:1634-638.
  7. Lundon K, Shupak R, Sunstrum-Mann L, Galet D, Schneider R: Leading change in the transformation of arthritis care: Development of an inter-professional academic-clinical education training model. / Healthcare Quarterly 2008, 11:59-5.
  8. Campos AA, Graveline C, Ferguson JM, Lundon K, Feldman BM, Schneider R, / et al.: The physical therapy practitioner (PTP) in pediatric rheumatology: high level of patient and parent satisfaction with services. / Physiother Can 2002, 54:32-6.
  9. Campos AA, Graveline C, Ferguson JM, Lundon K, Schneider R, Laxer RM: The physical therapy practitioner: an expanded role for physical therapy in pediatric rheumatology. / Physiother Can 2001, 53:282-87.
  10. Robarts S, Kennedy D, MacLeod AM, Findlay H, Gollish J: A framework for the development and implementation of advanced practice roles for physiotherapists that improves access and quality of care for patients. / Healthcare Quarterly 2008, 11:67-5.
  11. The Chartered Society of Physiotherapy: Chartered Physiotherapists Working as Extended Scope Practitioners (ESP): Guidance for Members. London, UK, The Chartered Society of Physiotherapy 2003.
  12. Shipton D, Badley EM, Mahomed NN: Critical shortage of orthopaedic services in Ontario, Canada. / Journal of Bone and Joint Surgery 2003, 85:1710-715.
  13. Hochberg MC: Early aggressive DMARD therapy: the key to slowing disease progression in rheumatoid arthritis. / Scand J Rheumatol Suppl 1999, 112:3-. 499750042227">CrossRef
  14. Quinn MA, Conaghan PG, Emery P: The therapeutic approach of early intervention for rheumatoid arthritis: what is the evidence? / Rheumatology 2001, 40:1211-220. 40.11.1211">CrossRef
  15. Nell VP, Machold KP, Eberl G, Stamm TA, Uffmann M, Smolen JS: Benefit of very early referral and very early therapy with disease-modifying anti-rheumatic drugs in patients with early rheumatoid arthritis. / Rheumatology 2004, 43:906-14. CrossRef
  16. Kersten P, McPherson K, Lattimer V, Steve G, Breton A, Ellis B: Physiotherapy extended scope of practice: who is doing what and why? / Physiotherapy 2009, 93:235-42. CrossRef
  17. Bourne RB: / Total Joint Replacements in Ontario Ottawa: Ontario Ministry of Health and Long-Term Care 2004.
  18. Canizares M, Soever L: / Access to orthopaedic services for arthritis / 2005-5 Edition Toronto: Arthritis Community Research & Evaluation Unit (ACREU) 2005.
  19. Snider MG, MacDonald SJ, Pototschnik R: Waiting times and patient perspectives for total hip and knee arthroplasty in rural and urban Ontario. / Can J Surg 2005, 48:355-60.
  20. / Wait Time Alliance for Timely Access to Health Care. It's about time! Achieving benchmarks and best practices in wait time management Ottawa, ON: Canadian Medical Association 2005.
  21. Gross AE: / Report of the total hip and knee joint replacement expert panel Ottawa, ON: Total Hip and Knee Joint Replacement Expert Panel 2005.
  22. Aiken AB, Harrison MM, Atkinson M, Hope J: Easing the burden for joint replacement wait times: the role of the extended practice physiotherapists. / Healthcare Quarterly 2008, 11:62-6.
  23. Li LC, Iversen MD: Outcomes of patients with rheumatoid arthritis receiving rehabilitation. / Curr Opin Rheumatol 2005, 17:172-76. 401.11028.88">CrossRef
  24. O'Cathain A, Froggett M, Taylor MP: General practice based physiotherapy: its use and effect on referrals to hospital orthopaedics and rheumatology outpatient departments. / British Journal of General Practice 1995, 45:352-54.
  25. Hourigan PG, Weatherley CR: The physiotherapist as an orthopaedic assistant in a back pain clinic. / Physiotherapy 1995, 81:546-48. 406(05)66692-8">CrossRef
  26. Hourigan PG, Weatherley CR: The physiotherapist as an orthopaedic assistant in a back pain clinic. / Physiotherapy 2003, 1995 Sep; 81:546-48.
  27. Hattam P: The effectiveness of orthopaedic triage by extended scope physiotherapists. / Clinical Governance: An International Journal 2004, 9:244-52. 4777270410566661">CrossRef
  28. Roland MO, Porter RW, Matthews JG, Redden JF, Simonds GW, Bewley B: Improving care: a study of orthopaedic outpatient referrals. / British Medical Journal 1991, 302:1124-128. 4">CrossRef
  29. Elwyn GJ, Stott NCH: Avoidable referrals? Analysis of 170 consecutive referrals to secondary care. / British Medical Journal 1994, 309:576-78.
  30. Position statement -Specialisation [http://www.wcpt.org/node/29536] The World Confederation for Physical Therapy (WCPT) 2008.
  31. Carr A: Defining the extended clincial role for allied health professionals in rheumatology. Gordon, T. ACR Conference Proceedings No. 12. UK, Arthirtis Research Campaign 2001.
  32. Dillman DA: / Mail And Telephone Surveys: The Total Design Method New York: Wiley 1978.
  33. Salant P, Dillman DA: / How to Conduct Your Own Survey New York: Wiley 1989.
  34. MacKay C, Veinot P, Badley EM: An overview of developments in comprehensive interdisciplinary models of care for arthritis: Provider and patient perspectives. Arthritis Community Research & Evaluation Unit (ACREU) 2006.
  35. Woodhouse L, The Advanced Practice Physiotharpy Task Force: Discussion Paper: Advanced Practice Physiotherapy in Ontario. A Proposal for Registered Physiotherapist Extended Class -Musculoskeletal Example. Ontario, Ontario Physiotherapy Association 2006.
  36. Li LC, Badley EM, MacKay C, Mosher D, Jamal S, Jones A, / et al.: An evidence-informed, integrated framework for rheumatoid arthritis care. / Arthritis Rheum 2008, 59:1171-183. CrossRef
  37. Happel B, Rushworth L: Can educational methods influence the popularity of psychiatric nursing? / Nurse Education Today 2002, 20:318-26. 4/nedt.1999.0432">CrossRef
  38. Jette AM, Becker MC: Nursing, occupational therapy and physical therapy prepartion in rheumatology in the United States and Canada. / J Allied Health 1980, 9:268-75.
  39. Westby MD: Rheumatology instruction in physical therapy undergraduate programs: a survey of Canadian universities. / PHYSIOTHER CAN 1999, 51:264-67.
  40. Almeida C, Clarke B, O'Brien A, Hammond A, Ryan S, Kay L, / et al.: Current provision of rheumatology education for undergraduate nursing, occupational therapy and physiotherapy students in the UK. / Rheumatology 2006, 45:868-73. CrossRef
  41. Hewlett S, Clarke B, O'Brien A, Hammond A, Ryan S, Kay L, / et al.: Rheumatology education for undergraduate nursing, physiotherapy and occupational therapy students in the UK: standards, challenges and solutions. / Rheumatology 2008, 47:1025-030. CrossRef
  42. Wadey VMR, Tang ET, Abelseth G, Dev P, Olshen RA, Walker D: Canadian multidisciplinary core curriculum for musculoskeletal health. / J Rheumatol 2006, 34:567-80.
  43. The pre-publication history for this paper can be accessed here:472-6963/9/88/prepub" class="a-plus-plus">http://www.biomedcentral.com/1472-6963/9/88/prepub
  
• 作者单位：Linda C Li (1) (2)
  Marie D Westby (1) (3)
  Evelyn Sutton (4) (5)
  Marlene Thompson (6)
  Eric C Sayre (2) (7)
  Lynn Casimiro (8)
  
  1. Department of Physical Therapy, University of British Columbia, Vancouver, Canada
  2. Arthritis Research Centre of Canada, Vancouver, Canada
  3. Mary Pack Arthritis Program, Vancouver General Hospital, University of British Columbia, Vancouver, Canada
  4. Department of Medicine, Dalhousie University, Halifax, Canada
  5. Nova Scotia Arthritis Centre, Queen Elizabeth II Health Sciences Centre, Halifax, Canada
  6. St. Joseph's Hospital, London, Canada
  7. Department of Statistics and Actuarial Science, Simon Fraser University, Vancouver, Canada
  8. Academic Health Council, University of Ottawa, Ottawa, Canada
  

文摘

Background Since the last decade there has been a gradual change of boundaries of health professions in providing arthritis care. In Canada, some facilities have begun to adopt new arthritis care models, some of which involve physiotherapists (PT) working in extended roles. However, little is known about PTs' interests in these new roles. The primary objective of this survey was to determine the interests among orthopaedic physiotherapists (PTs) in being a certified arthritis therapist, a PT specialized in arthritis, or an extended scope practitioner in rheumatology, and to explore the associated factors, including the coverage of arthritis content in the entry-level physiotherapy training. Methods Six hundred PTs practicing in orthopaedics in Canada were randomly selected to receive a postal survey. The questionnaire covered areas related to clinical practice, perceptions of rheumatology training received, and attitudes toward PT roles in arthritis care. Logistic regression models were developed to explore the associations between PTs' interests in pursuing each of the three extended scope practice designations and the personal/professional/attitudinal variables. Results We received 286 questionnaires (response rate = 47.7%); 258 contained usable data. The average length of time in practice was 15.4 years (SD = 10.4). About 1 in 4 PTs agreed that they were interested in assuming advanced practice roles (being a certified arthritis therapist = 28.9%, being a PT specialized in rheumatology = 23.3%, being a PT practitioner = 20.9%). Having a caseload of ?40% in arthritis, having a positive attitude toward advanced practice roles in arthritis care and toward the formal credentialing process, and recognizing the difference between certification and specialisation were associated with an interest in pursing advanced practice roles. Conclusion Orthopaedic PTs in Canada indicated a fair level of interest in pursuing certification, specialisation and extended scope practice roles in arthritis care. Future research should focus on the effectiveness and cost-effectiveness of the emerging health service delivery models involving certified, specialized or extended scope practice PTs in the management of arthritis.