Section 2. Knowledge of current practice recommendations, cardiovascular parameters, risk factors, blood pressure measurement technique and clinical management | |||
Are you familiar with guidelines relevant to cardiovascular parameters assessment? | N | % | 95 CI |
Yes | 106 | 27.2 | 22.8-31.7 |
No | 281 | 72.2 | 67.8-76.7 |
Which international guidelines are you familiar witha | |||
NICE | 43 | 40.6 | 31.2-49.9 |
American Heart Association | 58 | 54.7 | 45.2-64.2 |
Italian Society of Hypertension | 26 | 25.5 | 16.3-32.7 |
European Society of Cardiology and European Society of Hypertension | 40 | 37.7 | 28.5-47.0 |
Do you consider cardiovascular assessment in your clinical practice? | |||
Yes | 311 | 79.9 | 76.0-83.9 |
No | 76 | 19.5 | 15.6-23.5 |
If not, why you don’t evaluate the cardiovascular parameters? | |||
Not relevant for my practice | 56 | 73.7 | 63.8-83.6 |
Outside the physical therapy’s scope | 6 | 7.9 | 1.8-14.0 |
Work in secondary care referral pathway | 14 | 18.4 | 9.7-27.1 |
If yes, what cardiovascular parameter do you evaluate? a | |||
Heart rate | 249 | 80.1 | 75.6-84.5 |
Blood pressure | 266 | 85.5 | 81.6-89.4 |
Oxygen saturation | 184 | 59.2 | 53.7-64.6 |
None | 4 | 1.3 | 0.0-2.5 |
If yes, what are the most relevant risk factors? a | |||
Smoke | 266 | 85.5 | 81.6-89.4 |
Diet | 151 | 48.6 | 43.0-54.1 |
Level of fitness | 146 | 46.9 | 41.4-52.5 |
Cholesterol | 165 | 53.1 | 47.5-58.6 |
Diabetes | 168 | 54.0 | 48.5-59.6 |
Obesity | 241 | 77.5 | 72.9-82.1 |
Chronic kidney disease | 39 | 12.5 | 8.9-16.2 |
Familiarity | 140 | 45.0 | 39.5-50.5 |
Old age | 42 | 13.5 | 9.7-17.3 |
Socioeconomic level | 10 | 3.2 | 1.3-5.2 |
Gender | 10 | 3.2 | 1.3-5.2 |
Sleep apnea | 37 | 11.9 | 8.3-15.5 |
Stress | 80 | 25.7 | 20.9-30.6 |
Which are the normal, high-normal blood pressure ranges (systolic blood pressure; diastolic blood pressure) defined in the most recent guidelines? | |||
Normal (SBP<130/DBP<85) | 260 | 66.8 | 62.2-71.5 |
High-normal (SBP =130-139/DBP=85-89) | 64 | 16.5 | 12.8-20.1 |
Hypertension (SBP >140/DBP>90) | 47 | 12.1 | 8.8-15.3 |
Which are the normative values of the heart rate defined in the most recent guidelines? | |||
Normal (HR=60-100 bpm) | 305 | 78.4 | 74.3-82.5 |
Bradycardia (HR<60bpm) | 95 | 24.4 | 20.2-28.7 |
Tachycardia (HR>100bpm) | 102 | 26.2 | 21.9-30.6 |
Have you ever received an adequate training, or have you ever done any specific courses on the measurement of the cardiovascular parameters? | |||
Yes | 121 | 31.1 | 26.5-35.7 |
No | 266 | 68.4 | 63.8-73.0 |
If yes, where did you learn these notions? a | |||
Workplace | 45 | 37.2 | 28.6-45.8 |
Continuing Professional Development courses | 42 | 34.7 | 26.2-43.2 |
During the Bachelor | 91 | 75.2 | 67.5-82.9 |
During the Master | 14 | 11.6 | 5.9-17.3 |
Interaction with other healthcare professionals | 50 | 41.3 | 32.5-50.1 |
Personal readings (scientific books or literature) | 27 | 22.3 | 14.9-29.7 |
Social media and Podcast | 14 | 11.6 | 5.9-17.3 |
How relevant is cardiovascular parameters assessment in your practice? | Mean | SD | |
Likert (0-10) | 7.4 | 2.1 | |
Do you measure blood pressure and/or heart rate in your practice? | N | % | 95 CI |
Yes | 196 | 50.4 | 45.4-55.4 |
No | 186 | 47.8 | 42.9-52.8 |
If no, why? | |||
Outside the physical therapy scope of practice | 112 | 60.2 | 53.2-67.2 |
Working in a secondary care referral pathway (patients previously evaluated by a physician) | 73 | 39.2 | 32.2-46.3 |
Not trained adequately | 43 | 23.1 | 17.1-29.2 |
Requires too much time | 20 | 10.8 | 6.3-15.2 |
Quantify your ability in conducting a blood pressure assessment | |||
Not confident | 5 | 1.3 | 0.2-2.4 |
Insecure | 73 | 18.8 | 14.9-22.6 |
Quite sure | 204 | 52.4 | 47.5-57.4 |
Sure | 104 | 26.7 | 22.3-31.1 |
Quantify your confidence in interpreting the findings within your blood pressure assessment | |||
Not confident | 11 | 2.8 | 1.2-4.5 |
Insecure | 104 | 26.7 | 22.3-31.1 |
Quite sure | 213 | 54.8 | 49.8-59.7 |
Sure | 55 | 14.1 | 10.7-17.6 |
Quantify your confidence in managing the findings within your blood pressure assessment disorders | |||
Not confident | 14 | 3.6 | 1.7-5.4 |
Insecure | 139 | 35.7 | 31.0-40.5 |
Quite sure | 188 | 48.3 | 43.4-53.3 |
Sure | 41 | 10.5 | 7.5-13.6 |
Quantify your ability in conducting a heart rate assessment | |||
Not confident | 6 | 1.5 | 0.3-2.8 |
Insecure | 64 | 16.5 | 12.8-20.1 |
Quite sure | 199 | 51.2 | 46.2-56.1 |
Sure | 116 | 29.8 | 25.3-34.4 |
Quantify your confidence in interpreting the findings within your heart rate assessment | |||
Not confident | 11 | 2.8 | 1.2-4.5 |
Insecure | 115 | 29.6 | 25.0-34.1 |
Quite sure | 189 | 48.6 | 43.6-53.6 |
Sure | 70 | 18.0 | 14.2-21.8 |
Quantify your confidence in managing the findings within your heart rate assessment | |||
Not confident | 14 | 3.6 | 1.7-5.4 |
Insecure | 147 | 37.8 | 33.0-42.6 |
Quite sure | 166 | 42.7 | 37.8-47.6 |
Sure | 58 | 14.9 | 11.4-18.4 |
How many baseline blood pressure measurements are recommended? | |||
Other (<3, >3) | 194 | 49.9 | 44.9-54.8 |
3 | 181 | 46.5 | 41.6-51.5 |
Where should the blood pressure measurement have to be performed? | |||
Other (left arm, right arm, no difference) | 288 | 74.0 | 69.7-78.4 |
Both | 97 | 24.9 | 20.6-29.2 |
If both, which indications should be given to the patient? | |||
Other (Monitor both arms, Average the measurements of the two arms, No specific indication) | 52 | 53.6 | 43.7-63.5 |
Monitor the arm with the highest blood pressure | 45 | 46.4 | 36.5-56.3 |
How would you manage any serious anomalies detected during the evaluation of cardiovascular parameters? a | |||
Monitoring patient’s symptoms | 258 | 66.3 | 61.6-71.0 |
Refer to general practitioner | 203 | 52.2 | 47.2-57.1 |
Referral to the emergency department | 166 | 42.7 | 37.8-47.6 |
Referral to a specialist | 128 | 32.9 | 28.2-37.6 |
Request further examination | 61 | 15.7 | 12.1-19.3 |
To what extent do you consider cardiovascular risk in your practice? | Mean | SD | |
Likert (0-10) | 4.2 | 2.3 | |
Do you screen for cardiovascular risk in your practice? | N | % | 95 CI |
Yes | 273 | 70.2 | 65.6-74.7 |
No | 112 | 28.8 | 24.3-33.3 |
Do you evaluate your patients’ cardiovascular fitness before exercises? | |||
Yes | 130 | 33.4 | 28.7-38.1 |
No | 256 | 65.8 | 61.1-70.5 |
If yes, what tools or tests do you use to assess the cardiovascular fitness of your patients? a | |||
Maximal incremental test | 12 | 9.2 | 4.3-14.2 |
6 minutes walking test | 86 | 66.2 | 18.0-26.2 |
3 minutes step up test | 25 | 19.2 | 12.5-26.0 |
Indirect tests | 48 | 36.9 | 28.6-45.2 |
None | 4 | 3.1 | 0.1-6.0 |
Do you monitor blood pressure values prior, during and/or post-exercise? | |||
Yes | 108 | 27.8 | 23.3-32.2 |
No | 277 | 71.2 | 66.7-75.7 |
If yes, please specify the current recommended upper blood pressure threshold (systolic blood pressure; diastolic blood pressure) triggering the cessation of exercise. | |||
Exaggerated Blood Pressure values (SBP>250/>DBP>115) | 23 | 21.3 | 13.6-29.0 |
Section 3. Formal education and personal opinions | |||
How much relevant do you consider training in cardiovascular parameter assessment? | Mean | SD | |
Likert (0-10) | 7.1 | 2.3 | |
How much relevant do you consider training in cardiovascular risk assessment/management (e.g., syncopal events, tachycardia etc.)? | |||
Likert (0-10) | 8.3 | 1.9 | |
How training in conducting cardiovascular assessment should be provided? a | N | % | 95 CI |
Within the under-graduate programs (Bachelor) | 320 | 82.3 | 78.5-86.1 |
Within post-graduate programs (Masters) | 81 | 20.8 | 16.8-24.9 |
Within Continuing Professional Development courses | 165 | 42.4 | 37.5-47.3 |
In the workplace | 185 | 47.6 | 42.6-52.5 |