Toye F1,2, Room J1,2, Barker K1,2
1Oxford University Hospitals NHS Foundation Trust, Physiotherapy Research Unit, Nuffield Orthopaedic Centre, Oxford, United Kingdom, 2University of Oxford, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford, United Kingdom
Background: Using a prospective, assessor blinded two-arm randomised controlled trial we tested a novel multi-component rehabilitation intervention to be delivered in patients' own homes versus standard care. A qualitative study to explore the acceptability of the interventions to the therapists responsible for delivering the treatment packages was embedded in the main trial.
Purpose: This study was undertaken to explore the experiences of physiotherapist and physiotherapy assistants delivering the CORKA treatment intervention in people's homes.
Methods: A purposive sample of physiotherapist and physiotherapy assistants were recruited from those delivering the CORKA trial intervention. We interviewed 5 physiotherapists and 6 physiotherapy assistants. This number is appropriate for qualitative methods. Participants were invited to undertake one semi-structured interview. The interview lasted 60 to 90 minutes. Interviews were audio recorded and the recordings transcribed verbatim. The transcripts were analysed using thematic analysis. This involves abstracting the essence of ideas into themes.
Results: We identified themes that can help us to understand the benefits and challenges of delivering treatment interventions in a person's home. These themes included: thinking outside the cubicle; seeing the bigger picture; balancing familiarity and anonymity; the personal benefits of generous practice. These themes cut across physiotherapists and assistants.
Conclusion(s): Our findings suggest that qualitative research can help us to understand the therapeutic process. The innovation of the study was to interview both physiotherapists and assistants treating people at home. Our findings suggest that treating patients in their own home encourages a more holistic approach that can have benefits for both patients and therapists. Findings also highlight implications for clinical education; these include a need to learn now to negotiate the borderline between professional and patient. This need applies to both physiotherapist and assistants.
Implications: These themes are transferable across settings and professional groups. They highlight the challenge of negotiating the space between professionals and patients, and show that qualitative research can help us to understand and address these challenges. The themes demonstrate the therapeutic and personal benefits of trying to understand how life is lived outside the hospital cubicle.
Keywords: qualitative research, knee arthroplasty, rehabilitation
Funding acknowledgements: This work was funded by the NIHR Health Technology Assessment, Project Reference Number: 12/196/08
Purpose: This study was undertaken to explore the experiences of physiotherapist and physiotherapy assistants delivering the CORKA treatment intervention in people's homes.
Methods: A purposive sample of physiotherapist and physiotherapy assistants were recruited from those delivering the CORKA trial intervention. We interviewed 5 physiotherapists and 6 physiotherapy assistants. This number is appropriate for qualitative methods. Participants were invited to undertake one semi-structured interview. The interview lasted 60 to 90 minutes. Interviews were audio recorded and the recordings transcribed verbatim. The transcripts were analysed using thematic analysis. This involves abstracting the essence of ideas into themes.
Results: We identified themes that can help us to understand the benefits and challenges of delivering treatment interventions in a person's home. These themes included: thinking outside the cubicle; seeing the bigger picture; balancing familiarity and anonymity; the personal benefits of generous practice. These themes cut across physiotherapists and assistants.
Conclusion(s): Our findings suggest that qualitative research can help us to understand the therapeutic process. The innovation of the study was to interview both physiotherapists and assistants treating people at home. Our findings suggest that treating patients in their own home encourages a more holistic approach that can have benefits for both patients and therapists. Findings also highlight implications for clinical education; these include a need to learn now to negotiate the borderline between professional and patient. This need applies to both physiotherapist and assistants.
Implications: These themes are transferable across settings and professional groups. They highlight the challenge of negotiating the space between professionals and patients, and show that qualitative research can help us to understand and address these challenges. The themes demonstrate the therapeutic and personal benefits of trying to understand how life is lived outside the hospital cubicle.
Keywords: qualitative research, knee arthroplasty, rehabilitation
Funding acknowledgements: This work was funded by the NIHR Health Technology Assessment, Project Reference Number: 12/196/08
Topic: Orthopaedics; Musculoskeletal: lower limb; Professional practice: other
Ethics approval required: Yes
Institution: Oxford University Hospitals NHS Foundation Trust
Ethics committee: South Central Oxford B
Ethics number: 15/SC/0019
All authors, affiliations and abstracts have been published as submitted.
