Browsing by Author "González Seguel, Felipe"
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Publication Evaluación del funcionamiento físico en cuidados críticos: encuesta nacional en más de 90 centros chilenos durante la pandemia por COVID-19(2022) González Seguel, Felipe; Cáceres-Parra, CamiloBackground: Physical functioning evaluation in intensive care units (ICUs) identifies rehabilitation requirements and response to interventions. Aim: To identify the usage rate of physical functioning measurement instruments in ICUs during the COVID-19 pandemic in Chile. Material and Methods: Lead physiotherapists representing different national ICUs were invited to answer a National online survey at the onset (T1) and at the first year of COVID-19 pandemic (T2). The usage rate (defined as “always”/“almost always”/“almost never”/“never”) of instruments assessing muscle strength, muscle mass, mobility, and physical performance was surveyed. Also, the reasons for selecting these instruments were requested. Results: We received responses from 94 and 93 ICUs at T1 and T2, respectively, of 111 eligible ICUs (55% public). Compared with T2, the usage rate of instruments was lower at T1, and significant only for Medical Research Sum-Score (MRC-SS) (p = 0.04) and handgrip dynamometry (p = 0.05). Considering the answers “always”, “almost always” and “almost never”, between 89% and 91% of the ICUs reported the use of the MRC-SS; between 70% and 73% reported the use of the Functional Status Score for the Intensive Care Unit; between 5% and 35% of the ICUs reported the use of the rest of mobility scales; and between 44%-45% of ICUs reported that muscle ultrasound was “almost never” used. The main reasons reported for selecting instruments were quick use and clinimetric properties. Conclusions: The usage rate of muscle strength assessments was frequent, while the use of mobility and muscle mass instruments recommended by the literature was poorly reported, which was lower at the onset of the pandemic.Item Inter-observer reliability of trained physiotherapists on the Functional Status Score for the Intensive Care Unit Chilean-Spanish version(2020) González Seguel, Felipe; Camus-Molina, Agustín; Cárcamo, Marcela; Hiser, Stephanie; Needham, Dale M.; Leppe, JaimePurpose: Evaluate inter-observer reliability of trained physiotherapists administering the Chilean-Spanish version of the Functional Status Score for the Intensive Care Unit (FSS-ICU).Methods: Six adult patients in a medical-surgical ICU were assessed and video-recorded by 1 of 2 expert physiotherapists. Twelve physiotherapists were then trained using recommended Spanish-language FSS-ICU materials. The 12 physiotherapists independently scored the FSS-ICU for the 6 video-recorded patients. Intraclass Correlation Coefficient (ICC) was used to evaluate the inter-observer reliability, and modified Bland-Altman plots evaluated agreement between the physiotherapists and experts.Results: This study was performed between May and August 2018. The FSS-ICU total score had a median score of 18 (range: 6 to 34) for the 6 patients. The ICC of the total score was 0.96 (95% CI, 0.92 to 1.00), and for each of the 5 individual FSS-ICU tasks, the ICC ranged between 0.87 and 0.92. The modified Bland-Altman plot revealed a mean difference of 0.6 (95% limits of agreement: -3.3 to 4.5).Conclusions: Twelve trained physiotherapists had excellent inter-observer reliability when administering the Chilean-Spanish FSS-ICU using videos of six critically ill patients, and had excellent agreement with an expert, revealing differences within the established minimal important difference. These findings provide new data supporting clinimetric properties of the Chilean-Spanish FSS-ICU.Item Modificaciones en las prácticas de los kinesiólogos de unidades de cuidados intensivos durante el primer año de pandemia por Covid-19 en Chile: encuesta nacional. Proyecto DeKUCI COVID-19(Universidad del Desarrollo. Facultad de Medicina, 2022) Cáceres Parra, Camilo Alonso; González Seguel, FelipeIntroducción: Las unidades de cuidados intensivos (UCI), debieron adaptarse a la demanda sanitaria generada por la pandemia por COVID-19. Con el fin de explorar como se desempeñaron los equipos de kinesiólogos intensivos, este estudio busca describir las modificaciones institucionales, laborales y asistenciales experimentadas por los kinesiólogos de UCI durante el primer año de pandemia. Metodología: Encuesta nacional chilena patrocinada por COLKINE y aprobada por CEC CAS-UDD. Se envió una encuesta a un kinesiólogo representante de cada UCI en Chile Obteniendo información de cuatro periodos: previo 15 de marzo de 2020 (P1), julio de 2020 (P2), octubre de 2020 (P3) y marzo de 2021 (P4). La información se recopiló de manera retrospectiva. Resultados: De 111 UCIs elegibles, se obtuvo información de los cuatro periodos en 84[76%] de los centros; predominando 49[58%] fuera de la región metropolitana, 48[57%] públicos. A nivel institucional, hubo cambios significativos en todos los periodos. En la cantidad de camas UCI (mediana[RIQ] en P1: 10[6-15], P2: 29,5[12-44], P3: 15[10.5-26.5], P4: 24[14-54]), cantidad de kinesiólogos (P1: 2[1-3], P2: 4.5[2-8], P3: 3[2-6], P4: 4[2-8]), 69[82%] incorporaron nuevos kinesiólogos durante P2 y la disponibilidad de kinesiólogo 24/7 aumento (P1: 53[64%], P2: 75[89%], P3: 74[88%] y P4:72[87%]). A nivel laboral, entre P2-P4 se cumplió la recomendación de carga laboral solo en la jornada diurna en día hábil. A nivel asistencial, en P2 hubo mayor uso de ecografía, prono, traslado intrahospitalario y entrega de turno con respecto al periodo P1. En cambio, la docencia clínica y el uso de cicloergómetros disminuyeron desde P1 a P2. Conclusiones: Primer estudio de carácter censal, analítico y trasversal en Chile para la kinesiología intensiva en pandemia. Existieron modificaciones significativas a nivel institucional, laboral y varias de ellas perduran hasta un año desde el inicio de ésta.