BARRIERS AND FACILITATORS TO USING STANDARDISED OUTCOME MEASURES IN STROKE REHABILITATION BY NEURO PHYSIOTHERAPISTS IN SAUDI ARABIA

N. Alhwoaimel¹, H. Almarzoug²

¹Prince Sattam bin Abdulaziz University, Physical Therapy and Health Rehabilitation, Alkharj, Saudi Arabia, ²Myoosteopathy Medical Centre, Physical Therapy, Riyadh, Saudi Arabia

Background: Standardised outcome measures (SOMs) measure the progression of patients' functioning or participation in situations such as work or household management. Monitoring patient status using SOMs is considered good clinical practice, and it can encourage patients to participate in activities such as moving in an environment or performing personal care. However, the use of SOMs among Saudi physiotherapists is unknown.

Purpose: This study explores the use of SOMs by physiotherapists working in stroke rehabilitation in Saudi Arabia. It also investigates the facilitators and barriers that influence the use of SOMs for stroke patients in Saudi Arabia.

Methods: Physiotherapists who work in Saudi Arabia and manage adult stroke patients were recruited for a cross-sectional observational study. An online survey administered a three-section questionnaire designed for this study. The first section collected demographic information; the second assessed the use of a list of SOMs recommended by the American Physical Therapy Association. The last explored factors that facilitate or hinder the use of SOMs in clinical practice. The data were analysed descriptively and reported using absolute and relative frequencies. Linear regression investigated the association between educational level, work experience, type of work facility and number of patients treated per week on the use of SOM.

Results: A total of 4,080 participants responded to the survey, and 138 physiotherapists completed it. The age of the subjects ranged from 23 to 70 years, with approximately 57% males and 43% females. The results employing the SOM showed that most participants (n = 136, 98.5%) used at least one outcome measure in clinical practice. The most used outcome measures in the current study were the Ashworth Scale, Berg Balance Scale and Functional Independence Measure. Regression analysis revealed that the privet facility and number of stroke patients managed per week were associated with the likelihood of more SOMs in clinical practice with p< 0.001 and p = 0.009, respectively).Facilitators and barriers to using SOMs exist at individual and organisational levels. A positive attitude towards the use of SOMs and the perceived benefit of their use in clinical decision making were strongly pronounced facilitators. Time restrictions and limited resources (i.e. the availability of equipment) were the most pronounced barriers in the current study.

Conclusions: The use of standardised outcome measures is an integral part of clinical practice that can help physiotherapists in clinical decision making and optimise patient communication. Neuro physiotherapists in Saudi Arabia seem to recognise the importance of using SOMs and have a positive attitude towards using them.

Implications: At the organisational level, sufficient time and adequate resources are needed to enhance the use of SOMs among physiotherapists. There is a need for a toolkit with the recommended standardised outcome measures and electronic health systems to enable all physiotherapists to access them easily. Future research should assess the use of SOMs among physiotherapists who work in musculoskeletal and paediatric physical therapy.

Funding acknowledgements: This research received no specific grant. The authors would like to acknowledge Prince Sattam bin Abdulaziz University for their support

Keywords:
Standardised outcome measures
Stroke rehabilitation

Topics:
Neurology: stroke

Did this work require ethics approval? Yes

Institution: Prince Sattam bin Abdulaziz University

Committee: Prince Sattam bin Abdulaziz University

Ethics number: RHPT/021/013