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M. Egloff1, S.C. Zambrano2
1Inselspital, Bern University Hospital, Department of Physiotherapy, Bern, Switzerland, 2University of Bern, Institute of Social and Preventive Medicine, Bern, Switzerland
Background: There is a growing need for physiotherapy in the care of palliative care patients, especially in hospital-based settings. However, there exist misconceptions about the role of physiotherapists in the care of this patient population and there is little information about the readiness of physiotherapists to work with palliative care patients. Therefore, a better understanding of how physiotherapists experience and perceive working with palliative care patients is needed.
Purpose: This study aimed to identify Swiss hospital-based physiotherapists’ perceptions and experiences of working with palliative care patients.
Methods: This study employed an online qualitative survey design, which enables both breadth in terms of the number of participants who can take part, as well as in-depth analyses, because the questions posed to participants are open-ended. German-speaking qualified physiotherapists working in hospitals across Switzerland were eligible for participation. Recruitment took place between March and April 2022 using a purposive sampling technique. Data was analysed using reflexive thematic analysis.
Results: In total, 75 hospital-based physiotherapists participated of which 68% had palliative care experience. Three main themes were identified in their responses:
1) Recognising the importance of palliative care,
2) the emotional impact on physiotherapists, and
3) the search for individual solutions.
Under the first theme were participants’ positive perceptions towards palliative care, including wanting an earlier involvement of palliative care, as well as more acknowledgement of the key role that physiotherapists can have in palliative care. The emotional impact encompassed the way in which participants were affected by difficult patient situations, but also a recognition of the rewards of working in palliative care, including learning valuable lessons for life. Under the last theme were all contents that highlighted how participants found a sense of security in their teams, their flexibility in setting adapted goals, and how experience was a facilitator.
1) Recognising the importance of palliative care,
2) the emotional impact on physiotherapists, and
3) the search for individual solutions.
Under the first theme were participants’ positive perceptions towards palliative care, including wanting an earlier involvement of palliative care, as well as more acknowledgement of the key role that physiotherapists can have in palliative care. The emotional impact encompassed the way in which participants were affected by difficult patient situations, but also a recognition of the rewards of working in palliative care, including learning valuable lessons for life. Under the last theme were all contents that highlighted how participants found a sense of security in their teams, their flexibility in setting adapted goals, and how experience was a facilitator.
Conclusions: The inability to work towards rehabilitative goals may be difficult for physiotherapists without experience in palliative care. Additionally, the confrontation with difficult patient situations may lead physiotherapists to experience emotional distress. However, physiotherapists seem to have exceptional resources within their own teams to cope with these cases. Many are even able to find meaning in their work with palliative patients and to transfer learned lessons to their own lives. With a focus on adapting treatment according to the patients’ condition, wishes and needs physiotherapists have an important role to play with this patient population, even as death nears. General professional, non-specialised, experience seems to be a facilitator for treating this patient group.
Implications: Physiotherapists seem to have a natural way of coping with difficult situations with support of their teams. In addition, hospital-based physiotherapists seem generally well equipped to treat palliative care patients. With adequate training, collegial support, and experience, physiotherapists would be ready to work with this patient population and their involvement in the care of palliative care patients should be promoted.
Funding acknowledgements: None
Keywords:
Palliative care
end-of-life
qualitative research
Palliative care
end-of-life
qualitative research
Topics:
Oncology, HIV & palliative care
Oncology, HIV & palliative care
Did this work require ethics approval? No
Reason: Following the established procedures by Swiss ethics committees, a ‘clarification of responsibility’ was submitted to the Bernese Cantonal Ethical Commission. After assessing the application, the local Ethical Commission declared themselves as not responsible, meaning that the research project was not subject to approval in Switzerland and could be performed. As this project was undertaken as part of a thesis at Cardiff University, an additional ethical application was submitted to Cardiff University’s “School of Medicine Research Ethics Committee”, from whom we received a favourable opinion on March 4th, 2022.
All authors, affiliations and abstracts have been published as submitted.
