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Confidence and Attitudes Toward Osteoarthritis Care Among the Current and Emerging Health Workforce: A Multinational Interprofessional Study

Briggs, AM; Hinman, RS; Darlow, B; Bennell, KL; Leech, M; Pizzari, T; Greig, AM; MacKay, C; Bendrups, A; Larmer, PJ; Francis-Cracknell, A; Houlding, E; Desmond, LA; Jordan, JE; Minaee, N; Slater, H
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http://hdl.handle.net/10292/13995
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Abstract
Objective: To measure confidence and attitudes of the current and emerging interprofessional workforce concerning osteoarthritis (OA) care. Methods: Study design is a multinational (Australia, New Zealand, Canada) cross-sectional survey of clinicians (general practitioners [GPs], GP registrars, primary care nurses, and physiotherapists) and final-year medical and physiotherapy students. GPs and GP registrars were only sampled in Australia/New Zealand and Australia, respectively. The study outcomes are as follows: confidence in OA knowledge and skills (customized instrument), biomedical attitudes to care (Pain Attitudes Beliefs Scale [PABS]), attitudes toward high- and low-value care (customized items), attitudes toward exercise/physical activity (free-text responses). Results: A total of 1886 clinicians and 1161 students responded. Although a number of interprofessional differences were identified, confidence in OA knowledge and skills was consistently greatest among physiotherapists and lowest among nurses (eg, the mean difference [95% confidence interval (CI)] for physiotherapist-nurse analyses were 9.3 [7.7-10.9] for knowledge [scale: 11-55] and 14.6 [12.3-17.0] for skills [scale: 16-80]). Similarly, biomedical attitudes were stronger in nurses compared with physiotherapists (6.9 [5.3-8.4]; scale 10-60) and in medical students compared with physiotherapy students (2.0 [1.3-2.7]). Some clinicians and students agreed that people with OA will ultimately require total joint replacement (7%-19% and 19%-22%, respectively), that arthroscopy is an appropriate intervention for knee OA (18%-36% and 35%-44%), and that magnetic resonance imaging is informative for diagnosis and clinical management of hip/knee OA (8%-61% and 21%-52%). Most agreed (90%-98% and 92%-97%) that exercise is indicated and strongly supported by qualitative data. Conclusion: Workforce capacity building that de-emphasizes biomedical management and promotes high-value first-line care options is needed. Knowledge and skills among physiotherapists support leadership roles in OA care for this discipline.
Date
2019
Source
ACR Open Rheumatology, Vol. 1, No. 4, June 2019, pp 219–235 DOI 10.1002/acr2.1032
Item Type
Journal Article
Publisher
Wiley-Blackwell
DOI
10.1002/acr2.1032
Publisher's Version
https://onlinelibrary.wiley.com/doi/10.1002/acr2.1032
Rights Statement
© 2019 The Authors. ACR Open Rheumatology published by Wiley Periodicals Inc on behalf of American College of Rheumatology. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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