Patients’ expectations of physiotherapy treatment for musculoskeletal conditions

  • McCrum C
  • Bryant E
  • Murtagh S
  • et al.
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Abstract

centres'; as increasing numbers of people are being treated in such centres after cardiac arrest. Methods/analysis: A cross-sectional survey design was chosen, to provide quantitative data. A postal questionnaire was chosen as it would have the advantage of a known denominator population. A questionnaire was sent to each of the 144 acute NHS hospital Trusts in England. One physiotherapist from each trust was invited to respond. Individual guidelines were considered met if they were reported as being met 'always' or 'almost always' by respondents. Results: 52 questionnaires were included in the analysis; an overall response rate of 36% was achieved. A number of areas for improvement were identified, where levels of adherence were low; from initial screening and assessment-to appropriate onward referrals. No significant difference was found between responding trusts-with and without heart attack centres-in terms of guideline adherence. Discussion and conclusions: This survey has provided a 'snap shot' of the provision of acute rehabilitation for patients with brain injury after cardiac arrest, in a number of hospital trusts across England. The results question the equity of acute rehabilitation for patients with brain injury after cardiac arrest; as adherence to guidelines varied between responding trusts, and individual trusts reported adhering to some guidelines only 'sometimes'. Further research into areas where adherence was low or varied is warranted. Added responses suggested that patient location within the trust was a factor influencing adherence to many of the guidelines, and as such it may be appropriate to review the patient pathway, with a view to improve consistency and quality of care. Impact and implications: This study highlights the need for further guidance towards appropriate acute rehabilitation after cardiac arrest; particularly as more people are surviving cardiac arrest, and understanding how brain injury can impact on the lives of these patients and their families. Organisational support is needed to either further adopt the existing brain injury guidelines or to produce more specific guidelines for survivors of cardiac arrest. Relevance: Research shows that the expectations a patient brings to treatment have important influences on the clinical relationship, experiences of treatment, the treatment process, outcomes and satisfaction with care. This influence means that patients' expectations are important for physiotherapists , service providers and researchers to take into account in approaches to care and treatment evaluations. Research highlights the need for a better understanding of expectations of physiotherapy treatment for musculoskeletal problems to enable more effective, high quality and cost-beneficial care. Purpose: The aim of this qualitative study was to explore prospective responses to an open comment item on patients' expectations of their physiotherapy treatment that was nested within a larger research project developing and validating the Brighton musculoskeletal Patient Reported Outcome Measure (BmPROM). Methods/analysis: The BmPROM is a generic patient self-report outcome measure developed to evaluate the effectiveness of physiotherapy treatment for musculoskeletal conditions. A validity and reliability study was undertaken with patients newly referred into five NHS physiotherapy outpatient departments in SE England. The outcome tool has open-comment items, which included a pre-treatment invitation to provide expectations of their physiotherapy treatment. A thematic analysis was undertaken of the expectations expressed to gain insights for physiotherapy practice and patient care. Results: Analysis was undertaken of 563 expectations of physiotherapy treatment expressed from 224 participants (mean 50.7 yrs [17-88 yrs]; 60% female) experiencing a range of musculoskeletal conditions (Lower limb: 30%, Upper limb: 25%, Spine: 28%, Other/multiple sites: 17%). Five key themes were identified. Three themes were outcome-related and desired effects of treatment; Reliev

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McCrum, C., Bryant, E., Murtagh, S., Hodgson, L., Canby, G., Finucane, L., … Moore, A. (2016). Patients’ expectations of physiotherapy treatment for musculoskeletal conditions. Physiotherapy, 102, e22–e23. https://doi.org/10.1016/j.physio.2016.10.032

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