Physiotherapy outcomes and staffing resources in open abdominal surgery patients

Author： MacKay Margaret R. Ellis Elizabeth

ISSN： 1532-5040

Source： Physiotherapy Theory and Practice, Vol.18, Iss.2, 2002-06, pp. : 75-93

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Abstract

The measurement of physiotherapy outcomes after abdominal surgery has rarely been undertaken in Australia. Under the financial pressures of the current health care environment, physiotherapists urgently need to develop clinical outcomes and accurate measures of resource utilization. This study investigated clinical outcomes and physiotherapy staffing resources in open abdominal surgery patients at two hospitals. The Abdominal Surgery Physiotherapy Outcomes Data Sheet (APODS), designed for this study, demonstrated good content validity and high intrarater and interrater reliability. The 30 subjects at each of the two hospitals were comparable in all preoperative and perioperative variables. Wide variations in the amount of physiotherapy resources were found between the two hospitals. Number of physiotherapy treatments was found to be correlated with preoperative ASA score (r = 0.35, p = 0.006), days of mechanical ventilation (r = 0.60, p < 0.001), and postoperative length of stay (r = 0.53, p < 0.001). Rates of restoration of mobility varied significantly, with hospital B subjects sitting out of bed earlier (p = 0.004) and able to mobilise independently earlier after surgery (p = 0.045) compared to hospital A. Overall rate of postoperative pulmonary complication rates was 43.3%. Development of clinical outcome measures in this area of physiotherapy is urgently needed in order to guide physiotherapy staffing, review clinical practices, and inform priorities for future research direction.