“Move, move, move. Even if it sometimes hurts a little.” – Perceptions of physiotherapy for patients undergoing heart valve surgery

Susanne Klotz, Daniel Kohlhofer, Daria Schefer, Eric Nijman, Caroline Clifford, Evaldas Girdauskas
Purpose:

This qualitative study explores the perceptions of physiotherapy by patients undergoing minimally invasive heart valve surgery.

Methods:

The qualitative interview study was embedded in a randomized controlled trial testing the effectiveness of an enhanced recovery after surgery (ERAS) programme for patients undergoing minimally invasive heart valve surgery versus treatment as usual. As part of the ERAS intervention, patients received physiotherapy prior and during hospitalization, whereas in the control group patients receive physiotherapy only during hospitalization. Six weeks following the intervention, semi-structured interviews were conducted to explore, among other themes within the interviews, the perception of physiotherapy. The transcribed interviews were subjected to qualitative content analysis.

Results:

Eighteen patients (22% female, mean age 51.3 years with a range of 19 to 71 years) were interviewed, eleven of them were allocated to the intervention group receiving ERAS. During content analysis, five themes with regard to the physiotherapy emerged in the intervention and the control group: “relationship between patient and physiotherapist”, active physiotherapeutic approaches and physical activity”, “passive physiotherapeutic approaches”, “interprofessional team”, and “general conditions of physiotherapy”. The  additional theme “absence of physiotherapy” occurred solely in the control group.

Conclusion(s):

Physical activity was perceived as the central component of physiotherapy; however, the therapy was affected by the relationship between the patient and the physiotherapist and the setting and context factors, in which physiotherapy occurs. Patients in the control group, compared to the intervention group, perceived a lack of physiotherapy during their hospital stay.

Implications:

Physiotherapists in acute care hospitals should carefully establish the therapeutic relationship between patients and themselves, as it seems to influence the perception of physiotherapy by the patients. In addition, the general conditions, in which physiotherapy takes place, should be considered. Future initiatives should critically look at the physiotherapeutic process in acute care in order to reduce the perceived absence of physiotherapy

Funding acknowledgements:
This work was funded by the Innovationsausschuss in the Gemeinsamer Bundesausschuss (funding code: 01NVF19028).
Keywords:
Enhanced Recovery After Surgery
qualitative research
heart valve surgery
Primary topic:
Cardiorespiratory
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
Local Psychological Ethics Committee of the University Medical Center
Provide the ethics approval number:
LPEK-0358
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
Yes

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