Dataset Information

Patient satisfaction with advanced physiotherapy practice internationally: Protocol for a systematic mixed studies review.

ABSTRACT:

Rationale

Patient satisfaction is a complex construct consisting of human and system attributes. Patient satisfaction can afford insight into patient experience, itself a key component of evaluating healthcare quality. Internationally, advanced physiotherapy practice (APP) extends across clinical fields and is characterised as a higher level of practice with a high degree of autonomy and complex decision making. Patient satisfaction with APP appears positive. While evidence synthesis of patient satisfaction with APP exists, no systematic review has synthesised evidence across clinical fields. Therefore, the objectives of this systematic review are 1) to evaluate patient satisfaction with APP internationally, and 2) to evaluate human and system attributes of patient satisfaction with APP.

Materials and methods

A systematic mixed studies review using a parallel-results convergent synthesis design will be conducted. Searches of Medline, Embase, Web of Science, CINAHL, Cochrane, PEDro and grey literature databases will be conducted from inception to 18/7/2023. Studies of APP (World Physiotherapy definition) whereby practitioners a) have advanced clinical and analytical skills that influence service improvement and provide clinical leadership, b) have post-registration masters level specialisation (or equivalence), c) deliver safe, competent care to patients with complex needs and d) may use particular occupational titles; that measure patient satisfaction across all clinical fields and countries will be included. Two reviewers will screen studies, extract data, assess methodological quality of included studies (mixed methods appraisal tool), and contribute to data synthesis. Quantitative data will undergo narrative synthesis (textual descriptions) and qualitative data thematic synthesis (analytical themes). Integration of data syntheses will inform discussion.

Implications

This systematic review will provide insight into patient satisfaction with APP internationally, exploring attributes that influence satisfaction. This will aid design, implementation, or improvement of APP and facilitate the delivery of patient-centred, high-quality healthcare. Lastly, this review will inform future methodologically robust research investigating APP patient satisfaction and experience.

SUBMITTER: Davis C

PROVIDER: S-EPMC10588830 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Publications

Patient satisfaction with advanced physiotherapy practice internationally: Protocol for a systematic mixed studies review.

Davis Chris C Noblet Tim T Mistry Jai J Kowalski Katie K Rushton Alison A

PloS one 20231020 10

<h4>Rationale</h4>Patient satisfaction is a complex construct consisting of human and system attributes. Patient satisfaction can afford insight into patient experience, itself a key component of evaluating healthcare quality. Internationally, advanced physiotherapy practice (APP) extends across clinical fields and is characterised as a higher level of practice with a high degree of autonomy and complex decision making. Patient satisfaction with APP appears positive. While evidence synthesis of ...[more]

PMID: 37862302

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Project description:RationaleAdvanced Practice Physiotherapy (APP) is a post-licensure higher level of practice that requires distinctly increased skills, clinical reasoning and experience. The four pillars that underpin APP are clinical practice, leadership, education and research. Multiple systematic reviews support that APP is beneficial to health care systems. While APP exists in over a dozen countries, it has yet to reach international recognition. A steppingstone in gaining global acknowledgement is understanding the educational pathway that physiotherapists traverse to become Advanced Practitioners. No systematic review has synthesized evidence to describe and evaluate the educational pathway for physiotherapists to APP. Therefore, the objectives of this review are 1) to describe the post-licensure educational pathways that physiotherapists engage in to advance their level of practice, 2) to evaluate the pillars of APP demonstrated by the physiotherapist after traversing a post-licensure educational pathway.Materials and methodsA systematic mixed studies review using a data based convergent qualitative synthesis design will be conducted. MEDLINE (Ovid), Embase, CINAHL, the Cochrane Library, Web of Science, PEDro, SportDiscus, ProQuest Education databases as well as the grey literature will be searched from inception to 02/29/2024. Studies that aim to describe and or evaluate the capacity of educational pathways to influence the level of practice of the physiotherapist will be included. Two independent reviewers will screen studies, extract data and assess methodological quality (Quality Assessment of Diverse Studies). Quantitative data will be 'qualitized', and all data will be synthesized via a clustered textual description and directed content analysis. After synthesis, two reviewers will assess confidence in the cumulative evidence (GRADE-CERQual), which will inform the discussion.ImplicationsThe optimal pathway(s) to Advanced Practice for the physiotherapist will be evaluated to inform future high-quality research investigating the effectiveness of post-licensure education in developing Advanced Practice physiotherapists.

Project description:BackgroundPhysiotherapy can improve functional ability, prevent falls and reduce pain for older adults in nursing homes. However, there are no legislations or guidelines that specify the parameters of physiotherapy required in nursing homes. With the increasing healthcare demands of ageing populations worldwide, it is important to understand the current use of physiotherapy services to ensure they are both evidence-based and promote equity.Objectives(1) When and how are physiotherapy services used by older adults living in nursing homes? (2) What are the factors associated with use of physiotherapy services in nursing homes? (3) How are physiotherapy services in nursing homes documented and monitored?MethodsSeveral databases and grey literature (including MEDLINE, PubMed, Pedro and EMBASE) were searched following PRISMA guidelines in March 2018. Searches were limited to English language publications from 1997. Assessment for inclusion, data extraction and quality assessment were completed by two investigators independently using standardised forms. Studies were included if they considered any type of physiotherapy service that involved a qualified physiotherapist (such as exercise, massage and staff education) with older adults (aged 60 years and older) that were primarily permanent residents of a nursing home. Data extracted included proportion of clients that used physiotherapy services, type, frequency and duration of physiotherapy services, and factors associated with physiotherapy service use.ResultsEleven studies were included. Between 10% and 67% of nursing home clients used physiotherapy services. Factors associated with greater use of physiotherapy services included larger size facilities, and if clients had a physical impairment and mild or no cognitive impairment. Types of physiotherapy services reported were pain management and pressure ulcer management.ConclusionsPhysiotherapy service use in nursing homes varied widely. The development of physiotherapy benchmarks and quality standards are needed to support older adults in nursing homes. PROSPERO registration number: CRD42018082460.

Project description:BackgroundThe objective of this systematic review is to appraise evidence on the economic evaluations of advanced practice physiotherapy (APP) care compared to usual medical care.MethodsSystematic searches were conducted up to September 2021 in selected electronic bibliographical databases. Economic evaluation studies on an APP model of care were included. Economic data such as health care costs, patient costs, productivity losses were extracted. Methodological quality of included studies was assessed with the Effective Public Health Practice Project tool and the Critical Appraisal Skills Programme checklist. Meta-analyses were performed and mean differences (MD) in costs per patient were calculated using random-effect inverse variance models. Certainty of the evidence was assessed with the GRADE Approach.ResultsTwelve studies (n = 14,649 participants) including four randomized controlled trials, seven analytical cohort studies and one economic modeling study were included. The clinical settings of APP models of care included primary, emergency and specialized secondary care such as orthopaedics, paediatrics and gynaecology. The majority of the included participants were adults with musculoskeletal disorders (n = 12,915). Based on low quality evidence, health system costs including salaries, diagnostic tests, medications, and follow-up visits were significantly lower with APP care than with usual medical care, at 2 to 12-month follow-up (MD: - 145.02 €/patient; 95%CI: - 251.89 to - 38.14; n = 7648). Based on low quality evidence, patient costs including travel and paid medication prescriptions, or treatments were significantly higher with APP care compared to usual medical care, at 2 to 6-month follow-up (MD: 22.18 €/patient; 95%CI: 0.40 to 43.96; n = 1485). Based on very low quality evidence, no significant differences in productivity losses per patient were reported between both types of care (MD: 450 €/patient; 95%CI: - 80 to 970; n = 819).ConclusionsThis is the first systematic review and meta-analysis on the economic evaluation of APP models of care. Low quality evidence suggests that APP care might result in lower health care costs, but higher patient costs compared to usual medical care. Costs differences may vary depending on various factors such as the cost methodology used and on the clinical setting. More evidence is needed to evaluate cost benefits of APP models of care.

Project description:IntroductionPhysiotherapy assistants/support workers are an important part of the physiotherapy workforce in the UK. Many of them work in National Health Service (NHS) physiotherapy outpatient services treating patients with musculoskeletal (MSK) conditions. In many services, they take responsibility, under professional supervision, for types of clinical work traditionally undertaken by physiotherapists such as leading exercise classes and treating individual patients. Nevertheless, their role(s) are relatively undefined and as such, there is considerable variation in the duties and tasks they undertake. This study aims to design a framework of 'best practice' in delegation to guide the work of clinicians in NHS physiotherapy MSK services and facilitate standardisation of practice to ensure that patients receive safe and effective treatment by the most appropriate person.Methods and analysisThis mixed-methods study will be conducted in four stages. In stage 1, a focused ethnography in two MSK outpatient physiotherapy services will explore how the current use of delegation is informed by the culture within the clinical setting as well as views, attitudes about, and experiences of, delegation among clinicians, managers and patients. In stage 2a, nominal group technique will be used with three separate groups (physiotherapists/physiotherapy assistants/support workers, managers) to reach a consensus about what components should be included in a best practice framework of delegation. In stage 2b, a discrete choice experiment will elicit patients' preferences between care from physiotherapists and physiotherapy assistants/support workers within MSK physiotherapy services. In the final stage, the results of all previous stages will be triangulated to inform the development of a best practice delegation framework for future testing and use within NHS MSK outpatient physiotherapy services.Ethics and disseminationEthical approval has been granted by the South West-Frenchay Research Ethics Committee. The findings will be disseminated in peer-reviewed journals, conference presentations, the lay press and social media.

Dataset Information

Patient satisfaction with advanced physiotherapy practice internationally: Protocol for a systematic mixed studies review.

Rationale

Materials and methods

Implications

Publications

Patient satisfaction with advanced physiotherapy practice internationally: Protocol for a systematic mixed studies review.

Similar Datasets

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