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Confidence and Attitudes Toward Osteoarthritis Care Among the Current and Emerging Health Workforce: A Multinational Interprofessional Study
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| Zeitschriftentitel: | ACR Open Rheumatology |
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| Personen und Körperschaften: | , , , , , , , , , , , , , , , |
| In: | ACR Open Rheumatology, 1, 2019, 4, S. 219-235 |
| Format: | E-Article |
| Sprache: | Englisch |
| veröffentlicht: |
Wiley
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| Schlagwörter: |
| Zusammenfassung: | <jats:sec><jats:title>Objective</jats:title><jats:p>To measure confidence and attitudes of the current and emerging interprofessional workforce concerning osteoarthritis (<jats:styled-content style="fixed-case">OA</jats:styled-content>) care.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Study design is a multinational (Australia, New Zealand, Canada) cross‐sectional survey of clinicians (general practitioners [<jats:styled-content style="fixed-case">GP</jats:styled-content>s], <jats:styled-content style="fixed-case">GP</jats:styled-content> registrars, primary care nurses, and physiotherapists) and final‐year medical and physiotherapy students. <jats:styled-content style="fixed-case">GP</jats:styled-content>s and <jats:styled-content style="fixed-case">GP</jats:styled-content> registrars were only sampled in Australia/New Zealand and Australia, respectively. The study outcomes are as follows: confidence in <jats:styled-content style="fixed-case">OA</jats:styled-content> knowledge and skills (customized instrument), biomedical attitudes to care (Pain Attitudes Beliefs Scale [<jats:styled-content style="fixed-case">PABS</jats:styled-content>]), attitudes toward high‐ and low‐value care (customized items), attitudes toward exercise/physical activity (free‐text responses).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>A total of 1886 clinicians and 1161 students responded. Although a number of interprofessional differences were identified, confidence in <jats:styled-content style="fixed-case">OA</jats:styled-content> knowledge and skills was consistently greatest among physiotherapists and lowest among nurses (eg, the mean difference [95% confidence interval (<jats:styled-content style="fixed-case">CI</jats:styled-content>)] for physiotherapist‐nurse analyses were 9.3 [7.7‐10.9] for knowledge [scale: 11‐55] and 14.6 [12.3‐17.0] for skills [scale: 16‐80]). Similarly, biomedical attitudes were stronger in nurses compared with physiotherapists (6.9 [5.3‐8.4]; scale 10‐60) and in medical students compared with physiotherapy students (2.0 [1.3‐2.7]). Some clinicians and students agreed that people with <jats:styled-content style="fixed-case">OA</jats:styled-content> will ultimately require total joint replacement (7%‐19% and 19%‐22%, respectively), that arthroscopy is an appropriate intervention for knee <jats:styled-content style="fixed-case">OA</jats:styled-content> (18%‐36% and 35%‐44%), and that magnetic resonance imaging is informative for diagnosis and clinical management of hip/knee <jats:styled-content style="fixed-case">OA</jats:styled-content> (8%‐61% and 21%‐52%). Most agreed (90%‐98% and 92%‐97%) that exercise is indicated and strongly supported by qualitative data.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Workforce capacity building that de‐emphasizes biomedical management and promotes high‐value first‐line care options is needed. Knowledge and skills among physiotherapists support leadership roles in <jats:styled-content style="fixed-case">OA</jats:styled-content> care for this discipline.</jats:p></jats:sec> |
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| Umfang: | 219-235 |
| ISSN: |
2578-5745
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| DOI: | 10.1002/acr2.1032 |