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Caracterização da utilização de instrumentos autoreportados na fisioterapia músculo-esquelética em Portugal
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Abstract(s)
Enquadramento: As condições músculo-esqueléticas (ME) são a causa mais frequente de dor e incapacidade a longo prazo, sendo necessária uma avaliação contínua de resultados, nomeadamente através de instrumentos autoreportados pelos utentes (PROM’s). Contudo, a literatura mostra uma escassa utilização dos mesmos pelos fisioterapeutas na sua prática clínica, tornando-se essencial caracterizar a sua aplicação no contexto português, de forma a aumentar a avaliação de resultados através destes instrumentos. Objetivo: Este estudo teve como objetivo caracterizar a utilização de instrumentos autoreportados (PROM’s) pelos fisioterapeutas em utentes com condições músculo-esqueléticas, em Portugal, e identificar os fatores associados, as barreiras e os facilitadores à sua implementação. Metodologia: Realizou-se um estudo transversal com fisioterapeutas da área ME que trabalham em Portugal. O instrumento utilizado foi um questionário online e os participantes foram contactados via e-mail. A análise quantitativa dos dados foi realizada com recurso a estatística descritiva e inferencial, através de modelos de regressão logística. Os dados qualitativos foram submetidos a uma análise temática, na qual foram obtidas as barreiras e facilitadores identificados. Resultados: Foram obtidas 194 respostas ao questionário. A maioria dos fisioterapeutas não avalia resultados de forma consistente, sendo que os testes físicos são frequentemente escolhidos (70,5%) em detrimento de PROM’s (17,3%). Os domínios mais avaliados são a intensidade da dor (81,4%) e a funcionalidade dos utentes (51,3%), sendo que aspetos psicossociais como a depressão, ansiedade e distúrbios do sono são raramente avaliados (91,7%, 89,1% e 89,1%, respetivamente). O setor laboral, o número de utentes por hora, o estímulo no local de trabalho, a crença na valorização de PROM’s pelos utentes e a presença de conhecimentos necessários dos fisioterapeutas foram identificados como fatores associados à sua não utilização. As barreiras e facilitadores à utilização de PROM’s identificados estão relacionadas com as competências dos fisioterapeutas, as características dos utentes, as condições no local de trabalho e as características dos instrumentos. Conclusões: Apesar da amostra reduzida, verificou-se que existe uma escassa utilização de PROM’s pelos fisioterapeutas em Portugal. Foi identificado um conjunto de fatores associados, barreiras e facilitadores que devem ser considerados para aumentar a adesão na utilização de PROM’s por fisioterapeutas em Portugal.
Background: Musculoskeletal (MSK) conditions are the most frequent cause of long-term pain and disability, requiring a continuous outcome measurement, with the inclusion of patient-reported outcome measures (PROM's). However, the literature shows that patient- reported outcome measures are not consistently used by physiotherapists in their clinical practice, becoming essential to characterize its application in the portuguese context, in order to increase outcome measurement regarding these instruments. Objective: This study aims to characterize the use of patient-reported outcome measures (PROM's) by physiotherapists, in patients with musculoskeletal conditions, in Portugal, identifying the factors associated with its use and the barriers and facilitators to its implementation. Methodology: A cross-sectional study was carried out with musculoskeletal physiotherapists working in Portugal. The instrument used was an online survey and the participants were contacted via e-mail. The quantitative analysis of the data was performed with descriptive and inferential statistics, using a logistic regression model. The qualitative data were submitted to a thematic analysis, in which identified barriers and facilitators were obtained. Results: 194 physiotherapists answered the questionnaire. Most physiotherapists do not use outcome measures consistently and physical tests are often chosen (70,5%) over PROM's (17,3%). The most evaluated domains are pain intensity (81,4%) and disability (51,3%), with psychosocial aspects such as depression, anxiety and sleep disorders being rarely assessed (91,7%, 89, 1% and 89,1%, respectively). The work sector, the number of patients per hour, the stimulus in the workplace, the belief in the valorization of PROM's by patients and the presence of necessary knowledge from physiotherapists were identified as factors associated with the non-use of PROM’s. The identified barriers and facilitators to the use of PROM's are related to physiotherapists’ skills, the patients’ characteristics, the workplace conditions and the instruments’ characteristics. Conclusions: Despite the reduced sample, it was found that there is a low usage of PROM's by physiotherapists in Portugal. It was possible to identify the associated factors, barriers and facilitators that should be considered to increase the use of PROM’s by physiotherapists in Portugal.
Background: Musculoskeletal (MSK) conditions are the most frequent cause of long-term pain and disability, requiring a continuous outcome measurement, with the inclusion of patient-reported outcome measures (PROM's). However, the literature shows that patient- reported outcome measures are not consistently used by physiotherapists in their clinical practice, becoming essential to characterize its application in the portuguese context, in order to increase outcome measurement regarding these instruments. Objective: This study aims to characterize the use of patient-reported outcome measures (PROM's) by physiotherapists, in patients with musculoskeletal conditions, in Portugal, identifying the factors associated with its use and the barriers and facilitators to its implementation. Methodology: A cross-sectional study was carried out with musculoskeletal physiotherapists working in Portugal. The instrument used was an online survey and the participants were contacted via e-mail. The quantitative analysis of the data was performed with descriptive and inferential statistics, using a logistic regression model. The qualitative data were submitted to a thematic analysis, in which identified barriers and facilitators were obtained. Results: 194 physiotherapists answered the questionnaire. Most physiotherapists do not use outcome measures consistently and physical tests are often chosen (70,5%) over PROM's (17,3%). The most evaluated domains are pain intensity (81,4%) and disability (51,3%), with psychosocial aspects such as depression, anxiety and sleep disorders being rarely assessed (91,7%, 89, 1% and 89,1%, respectively). The work sector, the number of patients per hour, the stimulus in the workplace, the belief in the valorization of PROM's by patients and the presence of necessary knowledge from physiotherapists were identified as factors associated with the non-use of PROM’s. The identified barriers and facilitators to the use of PROM's are related to physiotherapists’ skills, the patients’ characteristics, the workplace conditions and the instruments’ characteristics. Conclusions: Despite the reduced sample, it was found that there is a low usage of PROM's by physiotherapists in Portugal. It was possible to identify the associated factors, barriers and facilitators that should be considered to increase the use of PROM’s by physiotherapists in Portugal.
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Keywords
Avaliação de resultados PROM’s Fisioterapia Portugal Outcome measurement Physiotherapy