Physiotherapists' ability to diagnose and manage shoulder disorders in an outpatient orthopedic clinic: results from a concordance study
| Autor: | Patrick Lavigne, Benjamin Léger-St-Jean, Alice Aiken, Véronique Lowry, Kadija Perreault, Alec Bass, Jean-Sébastien Roy, David Blanchette, François Desmeules, Simon Décary |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Concordance MEDLINE Ambulatory Care Facilities 03 medical and health sciences 0302 clinical medicine Shoulder Pain Surveys and Questionnaires Health care medicine Humans Orthopedics and Sports Medicine Aged 030222 orthopedics Shoulder Joint business.industry Orthopedic Surgeons 030229 sport sciences General Medicine Middle Aged Triage Confidence interval Test (assessment) Physical Therapists Cross-Sectional Studies Orthopedics Patient Satisfaction Orthopedic surgery Physical therapy Female Surgery Joint Diseases Orthopedic clinic business |
| Zdroj: | Journal of Shoulder and Elbow Surgery. 29:1564-1572 |
| ISSN: | 1058-2746 |
| Popis: | Background Advanced practice physiotherapy has emerged as a promising solution to improve health care access because access to orthopedic care is limited in several countries. However, evidence supporting advanced practice physiotherapy models for the management of shoulder pain remains scarce. The purpose of this study was to establish diagnostic, surgical triage, and medical imaging agreement between advanced practice physiotherapists (APPs) and orthopedic surgeons (OSs) for the management of patients with shoulder disorders in an outpatient orthopedic clinic. Methods Patients referred to an OS for shoulder complaints were recruited and independently assessed by an OS and an APP. Each provider completed a standardized form indicating diagnosis, imaging test requests, and triage of surgical candidates. Patient satisfaction with care was recorded with the 9-item Visit-Specific Satisfaction Questionnaire (VSQ-9). Inter-rater concordance was calculated with the Cohen κ, prevalence-adjusted bias-adjusted κ, and associated 95% confidence interval (CI). We used χ2 tests to compare differences between providers in terms of treatment plan options and Student t tests to compare patient satisfaction between providers. Results Fifty participants were evaluated. Good diagnostic agreement was observed between providers (κ, 0.80; 95% CI, 0.67-0.93). Agreement for triage of surgical candidates was moderate (κ, 0.46; 95% CI, 0.21-0.71) as APPs tended to refer patients more often to OSs for further evaluation. Imaging test request agreement was moderate as well (κ, 0.42; 95% CI, 0.19-0.66). Patient satisfaction with care was high, with no significant differences found between providers (P = .70). Conclusion APPs could improve access to orthopedic care for shoulder disorders by safely initiating patient care without compromising satisfaction. These results support further development and evaluation of APP care for orthopedic patients presenting with shoulder disorders. |
| Databáze: | OpenAIRE |
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