Toma de decisiones para el manejo ambulatorio de la bronquiolitis según fisioterapeutas docentes de la Universidad del Gran Rosario

Abstract

IntroductionClinical practice guidelines recommend against performing respiratory physiotherapy in children with bronchiolitis. It is unknown which interventions physiotherapists use in routine practice, and what factors influence their decisions. The aim was to characterize decision-making in outpatient management of bronchiolitis according to teaching physiotherapists from the University of Gran Rosario. Material and methodsA Delphi technique-based survey was conducted with physiotherapy teachers in 2 stages. The first stage involved a questionnaire with open-ended questions. The second stage was developed from the results of the first, consisting of closed-ended questions. A majority criterion was established among physiotherapists≥60%. ResultsA considerable variability was observed in the interventions considered for the management of bronchiolitis. Over 60% of professionals expressed full agreement that their interventions are based on their knowledge of basic sciences, scientific evidence, clinical evaluation, and academic training. Also, over 60% stated full agreement that the application of interventions depends on clinical aspects of the child, their socioeconomic context, and their family's commitment to treatment. ConclusionsThe clinical intervention process as informed by physiotherapists differs from clinical practice guidelines recommendations. Multiple factors seem to condition, according to the statements of consulted physiotherapists, decision-making in the outpatient management of bronchiolitis.