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Barreiras e facilitadores para a implementaĆ§Ć£o do programa Split.OA: um estudo qualitativoGomes,
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| 2.13 MB | Adobe PDF |
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Abstract(s)
IntroduĆ§Ć£o: A literatura revela que o exercĆcio fĆsico Ć© efetivo na reduĆ§Ć£o dos sintomas e melhoria da funĆ§Ć£o e qualidade de vida em pessoas com Osteoartrose da anca ou joelho
(OAAJ). Apesar das intervenƧƵes que envolvem programas de exercĆcio serem amplamente recomendadas, a literatura revela que a sua utilizaĆ§Ć£o Ć© subotima, assim como a aderĆŖncia dos fisioterapeutas Ć s recomendaƧƵes para a OAAJ. Implementar novas intervenƧƵes envolve mudanƧas na prĆ”tica clĆnica, os profissionais de saĆŗde sĆ£o um elemento-chave para o sucesso da implementaĆ§Ć£o. Melhorar a adoĆ§Ć£o de prĆ”ticas baseadas em evidĆŖncias implica estudar o comportamento dos principais envolvidos. Este estudo explora as barreiras e facilitadores dos fisioterapeutas Ć implementaĆ§Ć£o de um programa de exercĆcio estruturado, informado por mudanƧa comportamental, para pessoas com osteoartrose da anca ou joelho (Split.OA), em Portugal. Tem como objetivo identificar os determinantes dos comportamentos dos fisioterapeutas para a implementaĆ§Ć£o do Split.OA ser bem-sucedida. Metodologia: Foram realizados trĆŖs grupos focais, com um total de 18 fisioterapeutas portugueses, com base num guiĆ£o de entrevista semiestruturado e baseado nos modelos COM-B (capacidade, oportunidade e motivaĆ§Ć£o) e o Theoretical Domains Framework (TDF). Os grupos foram realizados atravĆ©s de videoconferĆŖncia, gravados em formato Ć”udio e vĆdeo, sendo posteriormente transcritos verbatim. Foi realizada uma anĆ”lise de conteĆŗdo dedutiva informada pelo COM-B e TDF por dois investigadores independentes. Resultados: Foram identificadas 13 barreiras (4 componentes do COM-B, 6 domĆnios do TDF) e 17 facilitadores (5 componentes do COM-B, 11 domĆnios do TDF) Ć implementaĆ§Ć£o de uma intervenĆ§Ć£o de exercĆcio estruturado, informada por mudanƧa comportamental, pelos fisioterapeutas portugueses. Barreiras como a ausĆŖncia de conhecimento de mudanƧa comportamental, capacidade para promover a adesĆ£o ao exercĆcio e programa, organizaĆ§Ć£o atual dos cuidados de saĆŗde foram identificados. O conhecimento das recomendaƧƵes para osteoartrose, a utilizaĆ§Ć£o do exercĆcio nas intervenƧƵes e a confianƧa nas capacidades para implementar o Split.OA foram
destacadas. ConclusƵes: Este estudo permitiu identificar as barreiras e facilitadores, pela perspetiva dos fisioterapeutas, Ć implementaĆ§Ć£o do Split.OA. Estes dados vĆ£o permitir,
posteriormente, informar o desenvolvimento de um programa de formaĆ§Ć£o para os fisioterapeutas, que atue a nĆvel dos determinantes identificados, para suportar os mesmos
na implementaĆ§Ć£o do Split.OA e que esta seja bem-sucedida.
Introduction: The literature indicates that physical exercise is effective in reducing symptoms and improving function and quality of life in individuals with Hip or Knee Osteoarthritis (HKOA). Despite interventions involving exercise programs being widely recommended, their utilization remains suboptimal, as does the adherence of physiotherapists to the recommendations for HKOA. Implementing new interventions involves changes in clinical practice, with healthcare professionals being a key element for successful implementation. Enhancing the adoption of evidence-based practices requires studying the behaviour of key stakeholders. This study explores the barriers and enablers for physiotherapists in implementing a structured exercise program, informed by behavioural change, for individuals with hip or knee osteoarthritis (Split.OA), in Portugal. It aims to identify the determinants of physiotherapists' behaviours for the successful implementation of Split.OA. Methodology: Three focus groups were conducted, comprising a total of 18 Portuguese physiotherapists, based on a semi-structured interview guide and grounded in the COMB (Capability, Opportunity, Motivation) models and the Theoretical Domains Framework (TDF). The groups were conducted via videoconference, recorded in audio and video formats, and subsequently transcribed verbatim. A deductive content analysis informed by COM-B and TDF was performed by two independent researchers. Results: 13 barriers (4 components of COM-B, 6 domains of TDF) and 17 facilitators (5 components of COM-B, 11 domains of TDF) to the implementation of a structured exercise intervention, informed by behavioural change, by Portuguese physiotherapists were identified. Barriers such as the absence of knowledge about behavioural change, capacity to promote adherence to the exercise and program, and the current organization of healthcare were identified. Knowledge of osteoarthritis recommendations, the use of exercise in interventions, and confidence in the capabilities to implement Split.OA were highlighted. Conclusions: This study identified barriers and facilitators, from the perspective of physiotherapists, to the implementation of Split.OA. These findings will subsequently inform the development of a training program for physiotherapists, targeting the identified determinants, to support them in the successful implementation of Split.OA.
Introduction: The literature indicates that physical exercise is effective in reducing symptoms and improving function and quality of life in individuals with Hip or Knee Osteoarthritis (HKOA). Despite interventions involving exercise programs being widely recommended, their utilization remains suboptimal, as does the adherence of physiotherapists to the recommendations for HKOA. Implementing new interventions involves changes in clinical practice, with healthcare professionals being a key element for successful implementation. Enhancing the adoption of evidence-based practices requires studying the behaviour of key stakeholders. This study explores the barriers and enablers for physiotherapists in implementing a structured exercise program, informed by behavioural change, for individuals with hip or knee osteoarthritis (Split.OA), in Portugal. It aims to identify the determinants of physiotherapists' behaviours for the successful implementation of Split.OA. Methodology: Three focus groups were conducted, comprising a total of 18 Portuguese physiotherapists, based on a semi-structured interview guide and grounded in the COMB (Capability, Opportunity, Motivation) models and the Theoretical Domains Framework (TDF). The groups were conducted via videoconference, recorded in audio and video formats, and subsequently transcribed verbatim. A deductive content analysis informed by COM-B and TDF was performed by two independent researchers. Results: 13 barriers (4 components of COM-B, 6 domains of TDF) and 17 facilitators (5 components of COM-B, 11 domains of TDF) to the implementation of a structured exercise intervention, informed by behavioural change, by Portuguese physiotherapists were identified. Barriers such as the absence of knowledge about behavioural change, capacity to promote adherence to the exercise and program, and the current organization of healthcare were identified. Knowledge of osteoarthritis recommendations, the use of exercise in interventions, and confidence in the capabilities to implement Split.OA were highlighted. Conclusions: This study identified barriers and facilitators, from the perspective of physiotherapists, to the implementation of Split.OA. These findings will subsequently inform the development of a training program for physiotherapists, targeting the identified determinants, to support them in the successful implementation of Split.OA.
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Keywords
Osteoartrose MudanƧa comportamental ExercĆcio Abordagem qualitativa Fisioterapia