Centre for Primary Care, Institute of Population Health, 5th Floor, Williamson Building, University of Manchester, Oxford Road, Manchester M13 9PL, United Kingdom.
Physiotherapy. 2013 Dec;99(4):335-40. doi: 10.1016/j.physio.2013.02.001. Epub 2013 Mar 16.
An exploratory study to examine specialist neurological physiotherapy service provision and utilisation for people with progressive ataxia.
Qualitative study involving thematic analysis of accounts in semi-structured interviews with physiotherapists and patients.
People with ataxia and specialist neuro-rehabilitation physiotherapists in Greater Manchester, UK.
38 people with ataxia and 8 neurological-physiotherapists working in academic and hospital and community-based services in NHS and private settings. Recruiting physiotherapists experienced in working with the patient group was a challenge.
One hour cross-sectional semi-structured interview at physiotherapists' workplaces or in patients' own homes.
Neurological physiotherapy was experienced by 25 (66%) of the 38 people with ataxia. The overarching themes emerging from the analysis were 'making a difference,' engagement and service provision. A majority of both samples felt that services should be organised so as to provide longer term therapy and support that goes beyond short care packages followed by provision of home exercise programme. Engagement with services was linked to patient expectations, adherence and perception of outcomes. The most predominant codes in the data set were encapsulated by the theme 'making a difference,' which further included concerns about how to measure perceived clinical improvement (as experienced by patients) in the context of progressive decline.
The findings suggest a model of idealised service provision involving a holistic, open-access service including research efforts to improve the evidence base. Special attention needs to be paid to measuring improvements following therapy.
探索性研究，旨在检查为进行性共济失调患者提供和利用专科神经物理治疗服务的情况。
半结构式访谈的定性研究，对物理治疗师和患者的访谈内容进行主题分析。
英国大曼彻斯特的共济失调患者和专科神经康复物理治疗师。
38 名共济失调患者和 8 名在 NHS 和私人机构的学术、医院和社区服务中工作的神经物理治疗师。招募有经验的治疗师参与该研究是一项挑战。
在物理治疗师的工作场所或患者自己的家中进行 1 小时的横断面半结构式访谈。
25 名（66%）38 名共济失调患者体验过神经物理治疗。分析中出现的主要主题是“有所作为”、参与和服务提供。两个样本的大多数人都认为，服务应该组织起来，提供长期的治疗和支持，超越短期护理套餐，之后提供家庭锻炼计划。与服务的互动与患者的期望、依从性和对结果的看法有关。数据集最主要的代码被主题“有所作为”所包含，这进一步包括如何在进行性下降的背景下衡量患者所经历的感知临床改善（患者体验）。
研究结果表明了一种理想的服务提供模式，包括整体、开放获取的服务，包括为改善证据基础而进行的研究工作。需要特别注意测量治疗后的改善情况。
