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Physiotherapists’ perspectives of barriers and facilitators to effective community provision after hip fracture: a qualitative study in England

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...

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Autores principales: Adams, Jodie, Jones, Gareth D, Sadler, Euan, Guerra, Stefanny, Sobolev, Boris, Sackley, Catherine, Sheehan, Katie J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10531122/
https://www.ncbi.nlm.nih.gov/pubmed/37756647
http://dx.doi.org/10.1093/ageing/afad130
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author Adams, Jodie
Jones, Gareth D
Sadler, Euan
Guerra, Stefanny
Sobolev, Boris
Sackley, Catherine
Sheehan, Katie J
author_facet Adams, Jodie
Jones, Gareth D
Sadler, Euan
Guerra, Stefanny
Sobolev, Boris
Sackley, Catherine
Sheehan, Katie J
author_sort Adams, Jodie
collection PubMed
description 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.
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spelling pubmed-105311222023-09-28 Physiotherapists’ perspectives of barriers and facilitators to effective community provision after hip fracture: a qualitative study in England Adams, Jodie Jones, Gareth D Sadler, Euan Guerra, Stefanny Sobolev, Boris Sackley, Catherine Sheehan, Katie J Age Ageing Qualitative Paper 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. Oxford University Press 2023-09-25 /pmc/articles/PMC10531122/ /pubmed/37756647 http://dx.doi.org/10.1093/ageing/afad130 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Qualitative Paper
Adams, Jodie
Jones, Gareth D
Sadler, Euan
Guerra, Stefanny
Sobolev, Boris
Sackley, Catherine
Sheehan, Katie J
Physiotherapists’ perspectives of barriers and facilitators to effective community provision after hip fracture: a qualitative study in England
title Physiotherapists’ perspectives of barriers and facilitators to effective community provision after hip fracture: a qualitative study in England
title_full Physiotherapists’ perspectives of barriers and facilitators to effective community provision after hip fracture: a qualitative study in England
title_fullStr Physiotherapists’ perspectives of barriers and facilitators to effective community provision after hip fracture: a qualitative study in England
title_full_unstemmed Physiotherapists’ perspectives of barriers and facilitators to effective community provision after hip fracture: a qualitative study in England
title_short Physiotherapists’ perspectives of barriers and facilitators to effective community provision after hip fracture: a qualitative study in England
title_sort physiotherapists’ perspectives of barriers and facilitators to effective community provision after hip fracture: a qualitative study in england
topic Qualitative Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10531122/
https://www.ncbi.nlm.nih.gov/pubmed/37756647
http://dx.doi.org/10.1093/ageing/afad130
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