Article type
Abstract
Background: Evidence-based self-management strategies in chronic disease management are associated with increased self-efficacy and health-related quality of life. Physiotherapists feel unprepared to promote these strategies in chronic musculoskeletal pain conditions.
Objective: To assess and promote exercise-centred self-management strategies for chronic musculoskeletal pain conditions in physiotherapy care.
Methods: JBI’s Practical audit tool of Clinical Evidence System and Getting Research into Practice was used. The project was conducted at a cooperating University Hospital of the Brandenburg Medical School Department of Physiotherapy. Barriers and facilitators to implementation were identified by qualitative interviews with musculoskeletal pain experts of the team (N = 5). All team members (N=16) were invited to complete a 31-item, standardized questionnaire to determine compliance to seven audit criteria. Results of the baseline audit informed the implementation strategy. Quantitative baseline audit methodology was used for post-implementation audit.
Results: In the baseline audit, 56% (N = 9) of team members responded to the questionnaire. Compliance to audit criteria ranged from 0% to 89%. Following qualitative data (N = 5 interviews), most relevant barriers to implementation represented the lack of knowledge on the facilitation of self-management strategies (including assessment of patient capabilities, pain education, goal-setting, self-monitoring and action plan development), as well as unstandardized documentation procedures at the department. The applied implementation strategy combined interactive educational training with the development of two standardized clinical assessment and documentation forms in which basic action and coping planning criteria were integrated. Moreover, a short-form exercise diary was developed to facilitate patient self-monitoring. In the follow-up audit, 75% (N = 12) of team members responded. Five out of seven audit criteria improved compared to baseline audit. A detailed display of results is provided in Figure 1.
Conclusions: A combination of interactive educational training, standardized physiotherapeutic assessment and documentation, and a short-form exercise diary implementation may be an appropriate strategy to increase compliance to exercise-related self-management facilitation.
Objective: To assess and promote exercise-centred self-management strategies for chronic musculoskeletal pain conditions in physiotherapy care.
Methods: JBI’s Practical audit tool of Clinical Evidence System and Getting Research into Practice was used. The project was conducted at a cooperating University Hospital of the Brandenburg Medical School Department of Physiotherapy. Barriers and facilitators to implementation were identified by qualitative interviews with musculoskeletal pain experts of the team (N = 5). All team members (N=16) were invited to complete a 31-item, standardized questionnaire to determine compliance to seven audit criteria. Results of the baseline audit informed the implementation strategy. Quantitative baseline audit methodology was used for post-implementation audit.
Results: In the baseline audit, 56% (N = 9) of team members responded to the questionnaire. Compliance to audit criteria ranged from 0% to 89%. Following qualitative data (N = 5 interviews), most relevant barriers to implementation represented the lack of knowledge on the facilitation of self-management strategies (including assessment of patient capabilities, pain education, goal-setting, self-monitoring and action plan development), as well as unstandardized documentation procedures at the department. The applied implementation strategy combined interactive educational training with the development of two standardized clinical assessment and documentation forms in which basic action and coping planning criteria were integrated. Moreover, a short-form exercise diary was developed to facilitate patient self-monitoring. In the follow-up audit, 75% (N = 12) of team members responded. Five out of seven audit criteria improved compared to baseline audit. A detailed display of results is provided in Figure 1.
Conclusions: A combination of interactive educational training, standardized physiotherapeutic assessment and documentation, and a short-form exercise diary implementation may be an appropriate strategy to increase compliance to exercise-related self-management facilitation.