QUALITATIVE RESEARCH IN PHYSIOTHERAPY: A SYSTEMATIC MAPPING REVIEW OF 20 YEARS LITERATURE FROM SUB-SAHARAN AFRICA

E.M. Anieto^1,2, A. Oko², C.O. Okeke^3,2, M. Ibekaku², U.O. Abaraogu⁴, M.E. Kalu^5,2

Background: Qualitative research is grossly misrepresented as a lesser status of non-experimental research within the hierarchy of evidence. This negatively impacts the teaching, learning, and usage of this type of research design. It is troubling because most health care models are shifting towards patient/family-centered approach. With the increasing acceptance of the biopsychosocial model in patients’ care, which at this stage in the physiotherapy profession needs more qualitative evidence, it is important to know the state of evidence regarding qualitative research conducted by physiotherapists.

Purpose: To summarize the current state and quality of qualitative research conducted by physiotherapists in sub-Saharan Africa.

Methods: Multiple databases were systematically searched for studies published between the year 2000 and April 2020. Peer-reviewed qualitative studies authored by physiotherapists in sub-Saharan African countries were included in the current study. Two reviewers independently screened citations, extracted data and performed the quality appraisal of the included articles using the 45-items checklist by Lundgren et al. (2012): research team and reflexivity (8-items), scope and purpose (2-items), study design (17-items), analysis and findings (14-items), and relevance and transferability (4-items). The quality of the included studies was rated as high (39-45 points), moderate (31-38) and low (≤30). A “best fit” framework synthesis approach was used to map the included articles across several areas of physiotherapy research.

Results: One hundred and five (105) studies meeting the inclusion criteria were included in the study, 82 (78.1%) of which were authored in South Africa. The existing qualitative studies were mapped under five headings: sports (n=2) disability (n=16), professional practice (n=19), education and training (n=35), and care provision (n=33).  Seventy-four (74) (70.5%) of the included studies were rated as being of low quality, while 23 (21.9%) and 8 (7.6%) were respectively rated as moderate, and high-quality peer-reviewed studies. Significant weaknesses in the included studies were mostly due to the lack of reports on researchers’ team characteristics, reflexivity, and relevance/transferability (e.g. member checking). Among the 8 studies rated high, six were published between 2018 to 2020, the other two in 2007 and 2012; 4 were professional practice research, and 2 each were disability and education/training research.

Conclusion(s): Most qualitative research authored by physiotherapists in sub-Saharan Africa is of low quality. Physiotherapy-researchers are encouraged to report reflexive practice and member checking when conducting qualitative research.

Implications: Enhancing the approaches towards qualitative research and integration of the evidence from qualitative research into practice is hugely dependent on clinical education and training research. Therefore, it is important for stakeholders of physiotherapy education in sub-Saharan Africa to review the current research training curriculum to address the gap in training research.

Funding, acknowledgements: The study was not funded.

Keywords: Qualitative research, physiotherapists, mapping review

Topic: Research methodology, knowledge translation & implementation science

Did this work require ethics approval? No

Institution: N/A

Committee: N/A

Reason: The study is a systematic mapping review. It involves collation and analysis of data from already published studies.