Physiotherapists' perspectives of barriers and facilitators to effective community provision after hip fracture: a qualitative study in England.
Age Ageing
; 52(9)2023 09 01.
Article
en En
| MEDLINE
| ID: mdl-37756647
ABSTRACT
PURPOSE:
to investigate physiotherapists' perspectives of effective community provision following hip fracture.METHODS:
qualitative semi-structured interviews were conducted with 17 community physiotherapists across England. Thematic analysis drawing on the Theoretical Domains Framework identified barriers and facilitators to implementation of effective provision. Interviews were complemented by process mapping community provision in one London borough, to identify points of care where suggested interventions are in place and/or could be implemented.RESULTS:
four themes were identified ineffective coordination of care systems, ineffective patient stratification, insufficient staff recruitment and retention approaches and inhibitory fear avoidance behaviours. To enhance care coordination, participants suggested improving access to social services and occupational therapists, maximising multidisciplinary communication through online notation, extended physiotherapy roles, orthopaedic-specific roles and seven-day working. Participants advised the importance of stratifying patients on receipt of referrals, at assessment and into appropriately matched interventions. To mitigate insufficient staff recruitment and retention, participants proposed return-to-practice streams, apprenticeship schemes, university engagement, combined acute-community rotations and improving job description advertisements. To reduce effects of fear avoidance behaviour on rehabilitation, participants proposed the use of patient-specific goals, patient and carer education, staff education in psychological strategies or community psychologist access. Process mapping of one London borough identified points of care where suggested interventions to overcome barriers were in place and/or could be implemented.CONCLUSION:
physiotherapists propose that effective provision of community physiotherapy following hip fracture could be improved by refining care coordination, utilising stratification techniques, employing enhanced recruitment and retainment strategies and addressing fear avoidance behaviours.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Fisioterapeutas
/
Fracturas de Cadera
Tipo de estudio:
Diagnostic_studies
/
Prognostic_studies
/
Qualitative_research
Límite:
Humans
País/Región como asunto:
Europa
Idioma:
En
Revista:
Age Ageing
Año:
2023
Tipo del documento:
Article
País de afiliación:
Reino Unido