物理治疗为主导的护理与低腰痛患者的医生为主导的护理:系统性审查
Pieter Severijns1, Nina Goossens1, Wim Dankaerts2
1REVAL Rehabilitation Research Center, UHasselt, Diepenbeek, Belgium.
Clinical rehabilitation
|September 27, 2024
概括
与医生主导的护理相比,以物理治疗为主导的腰部疼痛护理提高了患者的满意度,并降低了成本和医疗保健利用率. 然而,证据的确定性非常低,需要进一步研究.
科学领域:
- 骨科和肌肉骨系统疾病
- 医疗保健服务研究 医疗服务研究
- 基于证据的医学 基于证据的医学
背景情况:
- 腰部疼痛 (LBP) 是一种普遍存在的疾病,具有显著的医疗保健成本和对生活质量的影响.
- 对于LBP的最佳初始护理途径,无论由理疗师还是医生领导,仍然是调查的主题.
研究的目的:
- 系统地审查和总结证据,比较物理治疗和医生为腰部疼痛带领的护理.
- 评估对临床结果,医疗保健利用和相关成本的影响.
- 通过使用GRADE方法来评估证据的确定性.
主要方法:
- 在多个数据库 (PubMed,科学网,CINAHL,Embase,PEDro) 进行了系统的搜索.
- 包括的研究比较了临床结果,医疗保健的使用,或成本之间的成年人腰部疼痛最初咨询物理治疗师与医生.
- 使用纽卡斯尔-太华尺度评估方法质量,并以叙事方式综合发现.
主要成果:
- 分析了18项涉及140多万个人的研究.
- 在初级保健中,以理疗为主导的护理与更高的患者满意度,减少药物,注射和成像使用,更少的医生访问,更低的成本和更少的病假有关.
- 紧急护理设置显示,以理疗为主导的护理导致更短的等待时间和更少的住院病例,尽管在所有发现中,证据确定性非常低.
结论:
- 以理疗为主导的护理为管理腰部疼痛提供了临床有效,时间效率和成本效益的途径.
- 尽管发现一致,但证据的整体确定性非常低.
- 建议以临床结果为重点进行高质量的研究,以加强证据基础.
相关概念视频
Traditional Level Of Health Care System
The levels of care describe the services provided in the healthcare system. Accordingly, there are six levels of the traditional healthcare system in the US: preventive, primary, secondary, tertiary, restorative, and continuing healthcare. A nurse must understand how the healthcare industry organizes and provides services within these levels of care.
The preventive healthcare service includes tests for screening. Preventive health care services include identifying and reducing disease risk...
The preventive healthcare service includes tests for screening. Preventive health care services include identifying and reducing disease risk...
Restorative Care
Restorative care is provided once a patient has been discharged from a healthcare facility and requires additional services. The additional services include home care, rehabilitation programs, and extended care. Restorative care centers help the patient regain their previous level of functioning or acquire a new level of functioning due to the incapacitating effects of a disease or a disability. It aims to assist patients in enhancing their quality of life by encouraging independence,...
Specialized Care Centers and Settings-II
Rural Health Centers
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
Documentation in Long-Term and Home Healthcare Setting
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities
Peripheral Artery Disease IV: Nursing Management
The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses, temperature changes,...
Peripheral Artery Disease V: Postoperative Nursing Management
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...


