Physiotherapy - Research Publications
Permanent URI for this collection
Search Results
1 - 2 of 2
-
Item"I Was Really Pleasantly Surprised": Firsthand Experience and Shifts in Physical Therapist Perceptions of Telephone-Delivered Exercise Therapy for Knee Osteoarthritis-A Qualitative Study(WILEY, 2019-04)OBJECTIVE: To explore physiotherapists' perceptions before and after delivering exercise advice via telephone to patients with knee osteoarthritis (OA). METHODS: We performed a descriptive qualitative study (based on interpretivist methodology) embedded within a randomized controlled trial. Before and after providing exercise therapy to patients with knee OA, all 8 physiotherapists who were involved in the trial participated in semi-structured interviews via telephone. Interviews were audio recorded, transcribed verbatim, and thematically analyzed. RESULTS: Prior to delivering the intervention, physiotherapists thought that the telephone should be used only for follow-up rather than as the primary mode of providing care. They believed that telephone-delivered care would be convenient and cost-saving for patients, would provide increased opportunity for patient education, and also increase access to services, but that the lack of visual and physical contact with patients would be problematic. After delivering the intervention, physiotherapists reflected that telephone-delivered care exceeded their expectations, noting positive patient outcomes including improved pain, function, and confidence. The focus on communication allowed more personal conversations with patients and shifted patient expectations of care away from manual therapies and toward self-management. Numerous implementation considerations were identified, including the need for clinician training in communication skills, written resources for patients to supplement telephone calls, and careful deliberation of how to schedule telephone consultations during the usual in-person consultations in the clinic. CONCLUSION: Although physiotherapists were initially skeptical about the effectiveness of telephone-delivered service models to patients with knee OA, perceptions shifted once they experienced delivery of care via this nontraditional method. Our findings suggest that firsthand experience may be necessary for physiotherapists to embrace new models of service delivery.
-
ItemTraining Physical Therapists in Person-Centered Practice for People With Osteoarthritis: A Qualitative Case Study(WILEY, 2018-04)OBJECTIVE: To explore physical therapists' experiences with, and the impacts of, a training program in person-centered practice to support exercise adherence in people with knee osteoarthritis. METHODS: This was a qualitative case study using semi-structured interviews, nested within a clinical trial. Eight Australian physical therapists were interviewed before, and after, training in person-centered practice for people with knee osteoarthritis. Training involved a 2-day workshop, skills practice, and audit of 8 consultations with 4 patients (per therapist), and a final single-day workshop for audit feedback and consolidation. Semi-structured interviews were audio-recorded and transcribed verbatim. Data were thematically analyzed. RESULTS: Three pretraining themes arose regarding usual communication style, definitions of person-centered care, and sharing exercise adherence responsibility. Three themes related to the training experience emerged: learning a new language, challenging conceptions of practice, and putting it into practice. Post-training, 3 themes arose regarding new knowledge deepening understanding of person-centered care, changing beliefs about sharing responsibilities, and changed conceptions of role. CONCLUSION: Although physical therapists found training overwhelming initially as they realized the limitations of their current knowledge and clinical practice, they felt more confident and able to provide person-centered care to people with knee osteoarthritis by the end of training. Training in structured person-centered methodology that provides opportunity for skills practice with patients using a restructured consultation framework can change physical therapists' beliefs about their roles when managing patients with osteoarthritis and positively impact their clinical practice.