Abstract：
Introduction Advanced and extended primary health care practice roles have been developed in Aotearoa New Zealand (NZ) for dietetics, nursing, pharmacy, and physiotherapy professions. Advanced musculoskeletal physiotherapy roles in primary health care could address escalating health care costs, challenges to workforce sustainability and inefficient primary/secondary care interfaces. Little is known about how stakeholders perceive the recently introduced Advanced Practice Physiotherapist (APP) scope of practice. Aim This study aimed to explore health professionals\' perceptions of the APP scope of practice in NZ and how APPs could influence physiotherapy service delivery for people with musculoskeletal conditions in primary health care. Methods Qualitative, face-to-face, semi-structured interviews were conducted with 15 participants including physiotherapists, general practitioners, medical specialists and Accident Compensation Corporation case managers. Inductive interpretive analysis was undertaken. Results Five themes were identified: perceptions of current musculoskeletal management in primary health care; lack of a career pathway; ways in which APPs might facilitate change and what their role would be; characteristics of an APP; and the implementation of the APP role into practice. Discussion Stakeholders were supportive of the APP scope of practice and thought it has the potential to improve patient pathways, health care delivery and health outcomes for those with musculoskeletal conditions. Stakeholders also thought it would fill an important gap in the physiotherapy clinical career pathway. Successful implementation will require assessment of applicants\' personal attributes as well as clinical experience and academic qualifications to ensure all stakeholders have confidence to engage with the service, clear communication, active promotion and specific funding.
摘要：
介绍Aotearoa新西兰（NZ）为营养学开发了高级和扩展的初级卫生保健实践角色，护理,药房,和物理治疗专业。初级卫生保健中先进的肌肉骨骼理疗作用可以解决不断上升的卫生保健费用，对劳动力可持续性和低效的初级/二级保健接口的挑战。对于利益相关者如何看待最近引入的高级实践物理治疗师（APP）实践范围知之甚少。目的本研究旨在探讨卫生专业人员对新西兰APP实践范围的看法，以及APP如何影响初级卫生保健中肌肉骨骼疾病患者的理疗服务提供。定性方法，面对面,对包括物理治疗师在内的15名参与者进行了半结构化访谈，全科医生,医学专家和事故赔偿公司案件经理。进行了归纳解释分析。结果确定了五个主题：对初级卫生保健中当前肌肉骨骼管理的看法；缺乏职业途径；APP可能促进变革的方式及其作用；APP的特征；以及APP角色在实践中的实施。讨论利益相关者支持APP的实践范围，并认为它有可能改善患者的路径，肌肉骨骼疾病患者的医疗保健提供和健康结果。利益相关者还认为这将填补物理治疗临床职业途径中的重要空白。成功实施将需要评估申请人的个人属性以及临床经验和学历，以确保所有利益相关者都有信心参与服务，清晰的沟通,积极推动和专项资助。
