Developmental outcome measures in neonatal physiotherapy services of the United Kingdom: a survey of current use, and facilitators and barriers to their implementation

Abstract

Background and Purpose Current guidelines recognise the need for neonatal physiotherapists to provide surveillance assessments to neonates, from birth onwards. This study explored the current use, barriers and facilitators to using developmental outcomes measures in neonatal units, in the United Kingdom.

Method A cross-sectional, web-based survey with 32 items was piloted and distributed to members of the Association of Paediatric Chartered Physiotherapists and advertised on social media and professional discussion forums. Responses from the group of therapists who reported using outcome measures, were compared with those who reported not using them, using Mann-Whitney U tests for non-parametric data. Other findings were presented descriptively.

Results Forty-three completed surveys were analysed. Most respondents (91%) had a positive attitude towards the use of developmental outcome measures, and many (79%) used them in their neonatal practice. These included the General Movement Assessment (n=18/34), Hammersmith Neonatal Neurological Examination (n=16/34), and Lacey Assessment of Preterm Infants (n=15/34). The high cost of acquiring certain measures was a perceived barrier (86%). The presence of a neonatal-specialist physiotherapist (p=0.023), active engagement in continuous professional development (0.011) and support from fellow physiotherapists (p<0.001) significantly influenced outcome measure utilisation.

Conclusion Outcome measures were commonly used in the analysed units. Perceived utility and positive attitudes towards outcome measure use are in-line with current recommendations. This must be weighed up against the high acquisition cost of some measures. Further research is required to define tailored strategies for promoting best practice in the utilisation of specific developmental outcomes in neonatal care.