Improving screening for physical impairments and access to early physiotherapy after neck dissection surgery: a translational controlled trial.

Autor: McGarvey AC; Emergency Medicine Department, Calvary Mater Newcastle Hospital, Edith St, Waratah, Newcastle, NSW, 2298, Australia. Aoife.McGarvey@calvarymater.org.au.; Physio Living, New Lambton, NSW, Australia. Aoife.McGarvey@calvarymater.org.au.; School of Health Sciences, Faculty of Health, University of Newcastle, Callaghan, NSW, Australia. Aoife.McGarvey@calvarymater.org.au., Osmotherly PG; School of Health Sciences, Faculty of Health, University of Newcastle, Callaghan, NSW, Australia., Hoffman GR; School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, NSW, Australia.; John Hunter Hospital, New Lambton, NSW, Australia., Hall A; School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, NSW, Australia.
Jazyk: angličtina
Zdroj: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery [Eur Arch Otorhinolaryngol] 2021 Feb; Vol. 278 (2), pp. 509-516. Date of Electronic Publication: 2020 Jul 03.
DOI: 10.1007/s00405-020-06142-0
Abstrakt: Purpose: Lack of routine screening for a range of physical impairments that can result after neck dissection (ND) may hinder physiotherapy referral and treatment. The purpose of this study was to implement an intervention that targeted both physiotherapists and surgeons to increase their post-operative physical screening of ND patients and in turn improve physiotherapy referral rates.
Methods: The authors undertook a translational controlled pilot study, conducted over a 12-month period that utilised three tertiary hospital sites. The target groups were physiotherapists at one intervention site and surgeons at the other intervention site, with the third hospital acting as a control site and receiving usual care. The intervention included a physiotherapy brochure and a clinical pathway for screening, to promote early identification and prompt referral of patients with a physical impairment. The primary outcome variables were screening and referral rates between sites at the study end-point.
Results: Logistic regression analyses were conducted on n = 174 to assess differences in screening and referral rates between sites. Patients at the intervention site that targeted physiotherapists had four times the odds of being screened for shoulder dysfunction compared to the control site (p = 0.0002), and three times the odds of being referred to physiotherapy (0.0039). There were no statistically significant differences in the odds of patients being screened for shoulder dysfunction or referred to physiotherapy at the intervention site that targeted surgeons.
Conclusion: The translational intervention undertaken by physiotherapists resulted in significantly greater screening and referral rates of post-operative ND patients for physiotherapy.
Databáze: MEDLINE
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