障碍物和促进者,以实施长期的运动疗法的人与类风湿性关节炎或轴性脊髓关节炎
Annabelle R Iken1, Maaike G J Gademan1,2, Thea P M Vliet Vlieland1,3
1Department of Orthopaedics, Rehabilitation, and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands.
Rheumatology advances in practice
|February 16, 2026
概括
对类风湿性关节炎 (RA) 和轴性脊柱关节炎 (axSpA) 实施监督运动治疗面临挑战. 解决障碍,如不清楚的转诊和确保训练有素的物理治疗师可用,是有效的病人护理的关键.
科学领域:
- 类风湿病学 类风湿病学
- 康复医学 康复医学 康复医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 长期以来,个性化,监督的炼治疗对于具有严重功能限制的类风湿性关节炎 (RA) 和轴性脊柱关节炎 (axSpA) 患者来说是具有成本效益的.
- 尽管有政策支持,但将这种疗法纳入常规临床实践仍然具有挑战性.
研究的目的:
- 确定在临床实践中用于RA和axSpA的监督运动治疗的障碍和促进因素.
- 了解利益相关者对实施挑战的看法.
主要方法:
- 与患者,风湿病学家,理疗师和保险公司进行了18次半结构面试.
- 利用实施研究综合框架 (CFIR) 来指导采访和分析调查结果.
- 采用了面试成绩单的直接内容分析,将调查结果映射到CFIR领域,并在转诊,资格和治疗阶段对障碍/促进者进行分类.
主要成果:
- 确定了障碍,包括不清楚的资格标准,对训练有素的物理治疗师的限制,以及财务不确定性.
- 辅导人员指出,有强有力的证据表明疗法的有效性,一致的信息传递,明确的沟通道,以及物理治疗师的培训可用性.
- 利益相关者特定的障碍包括患者的坚持,风湿病学家的转诊途径,物理治疗师的资格评估和保险公司的财务覆盖.
结论:
- 长期以来的运动治疗的实施面临着多个阶段,多个利益相关方的挑战,尽管有政策支持.
- 需要一种协调的方法来克服障碍,并利用促进者.
- 战略应侧重于改善推流程,澄清资格,加强患者教育,并确保物理治疗师的适当培训.
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