Knowledge Of Treatment Recommendations Research Articles

Physiotherapy for cystic fibrosis in Australia: Knowledge and acceptance of the Consensus Statement recommendations

In 2008, a Consensus Statement was published with the aim of optimizing physiotherapy management for people with cystic fibrosis (CF) in Australia. The aim of this study was to measure knowledge and acceptance of the Consensus Statement recommendations. All physiotherapists providing treatment to people with CF in Australia were invited to complete a purpose-designed online survey to assess knowledge and uptake of key treatment recommendations. Sixty-eight physiotherapists took part (response rate 49%). Knowledge of treatment recommendations was high for airway clearance (94%) and exercise assessment (76%). Most respondents agreed with these recommendations (airway clearance 97% agreement, exercise 68% agreement). A small number of respondents (18%) correctly identified the current recommendation to segregate patients with different organisms during airway clearance, with most respondents (73%) implementing stricter infection control policies. Low levels of knowledge and agreement were evident for recommendations regarding measurement of blood sugar levels during exercise (36% knowledge and 28% agreement) and delivery of dornase alfa (53% and 65%). Physiotherapists from specialist CF centres were more likely to know the recommendations for blood sugar level measurement during exercise (P = 0.014), dornase alfa (P = 0.001) and non-invasive ventilation (P = 0.07) compared with physiotherapists in other settings. Physiotherapists are aware of treatment recommendations for CF in common areas of practice such as airway clearance and exercise. However, knowledge of recommendations is lower for specialized areas of practice and outside of CF centres. Strategies to improve awareness and uptake of the Consensus Statement among physiotherapists outside of CF centres are required.

Anästhesie in anästhesiefeindlicher Umgebung - Tätigkeitsfeld Rettungshubschrauber

Rescue helicopters are used for emergency care and transport of emergency patients. The dimension of the cabin is clearly limited. A transport is carried out under spatial narrowness and high noise levels. Acoustic alarms or noises caused by the patient are hardly to be perceived, so that the view at optical alarms is necessary. Environmental conditions affect the concentration on the patient. Rearrangement maneuvers represent the most critical phases. Always the whole apparative monitoring and respirator must be in the field of view of the emergency doctor, drugs to the care must be handy to be quickly administered, the quantity of oxygen has to be observed. Infusions and option of airway management are ready to set in advance. Standardized work with the aid of algorithms and knowledge of treatment recommendations and guidelines help to prevent errors. To optimize the care of emergency patients, special training courses for the crew of rescue helicopters are offered. A training simulator to practice different scenarios and the establishment of a CIRS system are recommended.

‘If it was osteoporosis, I would have really hurt myself.’ Ambiguity about osteoporosis and osteoporosis care despite a screening programme to educate fragility fracture patients

Behaviour change models suggest that people need clear information about their susceptibility to disease and knowledge of treatment recommendations in order to change their behaviour. The purpose of this qualitative study was to examine fracture patients' understanding of osteoporosis (OP) and OP care after being screened for, and educated about, OP in a fracture clinic. We conducted five focus groups with 24 patients (18 women, six men) aged 47-80 years old who were screened for OP through an urban fracture clinic. Participants were asked about their awareness of OP and their status of bone mineral density (BMD) testing and OP treatment. Twenty participants vocalized at least one expression of ambiguity regarding OP and/or treatment recommendations conveyed by the screening programme staff. Participants were ambiguous about the cause of their fracture, the BMD test process and results, and the presentation of OP. They were also ambiguous about the amount and type of medication and supplements recommended. Despite a standardized screening programme in which OP was addressed in fragility fracture patients, ambiguity about diagnosis, testing and treatment were described. Efforts to clarify information relayed to fracture patients about their condition and recommended care need to extend beyond the fracture clinic so that health care providers can promote long-term adherence to these recommendations.