Rushton Alison, Heneghan Nicola R, Heap Alison, White Louise, Calvert Melanie, Goodwin Peter C
Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, West Midlands, UK.
Physiotherapy, University Hospitals Birmingham NHS Foundation Trust, Birmingham, West Midlands, UK.
BMJ Open. 2017 May 4;7(4):e015878. doi: 10.1136/bmjopen-2017-015878.
To evaluate patients' and physiotherapists' perceptions, preferences and feelings about rehabilitation following lumbar discectomy surgery.
A qualitative focus group study, informed from the theoretical perspective of phenomenology, of patients' and physiotherapists' experiences of rehabilitation following lumbar discectomy was conducted. The focus groups were used to explore patients' and physiotherapists' perceptions and their preferences and feelings about different approaches to rehabilitation. The focus groups were facilitated and observed by experienced researchers and were informed by a topic guide that had been piloted previously.
The study was embedded within an external pilot and feasibility trial that randomised patients across two secondary care spinal surgery sites in the UK to receive either 1:1 physiotherapy and leaflet or leaflet-only interventions.
Five focus groups took place between April and July 2014. A framework analysis of thematic coding (deductive and inductive components) by two researchers captured identified themes common to both patients and physiotherapists. Data from three focus groups with patients and carers (n=11) and two with physiotherapists (n=15) contributed to the analytic framework.
Emerging themes included: the value of patient leaflets with or without physiotherapy interventions; the importance of self-motivation in the recovery pathway; benefits of group physiotherapy for some patient groups and patient preference influencing rehabilitation.
Patients and physiotherapists perceived the study patient leaflet and 1:1 physiotherapy interventions as high quality and valuable. Patients' personal priorities, for example, their need to return to work, influenced their preferences for rehabilitation interventions following surgery.
评估患者及物理治疗师对腰椎间盘切除术后康复的认知、偏好和感受。
采用定性焦点小组研究，从现象学理论角度出发，对腰椎间盘切除术后患者及物理治疗师的康复经历进行研究。焦点小组用于探讨患者及物理治疗师对不同康复方法的认知、偏好和感受。焦点小组由经验丰富的研究人员主持和观察，并依据之前试行过的主题指南进行。
该研究纳入了一项外部试点及可行性试验，将英国两个二级护理脊柱手术地点的患者随机分为两组，分别接受一对一物理治疗及宣传册或仅接受宣传册干预。
2014年4月至7月期间进行了五次焦点小组讨论。两名研究人员对主题编码（包括演绎和归纳部分）进行框架分析，确定了患者和物理治疗师共有的主题。来自三个患者及护理人员焦点小组（n = 11）和两个物理治疗师焦点小组（n = 15）的数据构成了分析框架。
出现的主题包括：有或无物理治疗干预的患者宣传册的价值；自我激励在康复过程中的重要性；团体物理治疗对部分患者群体的益处以及影响康复的患者偏好。
患者和物理治疗师认为该研究的患者宣传册及一对一物理治疗干预质量高且有价值。患者的个人优先事项，例如他们重返工作的需求，影响了他们对术后康复干预的偏好。
