Institute for Palliative Care, Lund University and Region Skåne, Lund, Sweden.
Faculty of Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
BMC Palliat Care. 2018 Jan 29;17(1):20. doi: 10.1186/s12904-018-0272-x.
A growing body of studies indicate benefits of physiotherapy for patients in palliative care, for symptom relief and wellbeing. Though physiotherapists are increasingly acknowledged as important members of palliative care teams, they are still an underutilized source and not fully recognized. The aim of this study was to explore the variety of activities described by physiotherapists in addressing the needs and problems of patients and their families in specialized palliative care settings.
Using a free-listing approach, ten physiotherapists working in eight specialized palliative care settings in Sweden described as precisely and in as much detail as possible different activities in which patients and their families were included (directly or indirectly) during 10 days. The statements were entered into NVivo and analysed using qualitative content analysis. Statements containing more than one activity were categorized per activity.
In total, 264 statements, containing 504 varied activities, were coded into seven categories: Counteracting a declining physical function; Informing, guiding and educating; Observing, assessing and evaluating; Attending to signs and symptoms; Listening, talking with and understanding; Caring for basic needs; and Organizing, planning and coordinating. In practice, however, the activities were intrinsically interwoven. The activities showed how physiotherapists aimed, through care for the body, to address patients' physical, psychological, social and existential needs, counteracting the decline in a patient's physical function and wellbeing. The activities also revealed a great variation, in relation not only to what they did, but also to their holistic and inseparable nature with regard to why, how, when, where, with whom and for whom the activities were carried out, which points towards a well-adopted person-centred palliative care approach.
The study provides hands-on descriptions of how person-centred palliative care is integrated in physiotherapists' everyday activities. Physiotherapists in specialized palliative care help patients and families to bridge the gap between their real and ideal everyday life with the aim to maximize security, autonomy and wellbeing. The concrete examples included can be used in understanding the contribution of physiotherapists to the palliative care team and inform future research interventions and outcomes.
越来越多的研究表明，物理疗法对姑息治疗患者有好处，可以缓解症状和提高幸福感。尽管物理治疗师越来越被认为是姑息治疗团队的重要成员，但他们仍然没有得到充分利用，也没有得到充分认可。本研究的目的是探讨在专门的姑息治疗环境中，物理治疗师为满足患者及其家属的需求和解决问题而描述的各种活动。
使用自由列表法，10 名在瑞典 8 个专门的姑息治疗环境中工作的物理治疗师尽可能详细地描述了在 10 天内患者及其家属（直接或间接）参与的不同活动。这些陈述被输入到 NVivo 中，并使用定性内容分析进行分析。包含多项活动的陈述按每项活动进行分类。
总共 264 条陈述，包含 504 种不同的活动，被编码为 7 个类别：对抗身体功能下降；信息、指导和教育；观察、评估和评价；处理症状；倾听、交谈和理解；照顾基本需求；组织、计划和协调。然而，在实践中，这些活动是内在交织在一起的。这些活动表明，物理治疗师通过身体护理，旨在满足患者身体、心理、社会和存在的需求，对抗患者身体功能和幸福感的下降。这些活动还揭示了很大的差异，不仅与他们所做的有关，而且与他们整体的、不可分割的性质有关，即为什么、如何、何时、何地、与谁以及为谁开展这些活动，这表明他们采取了一种很好的以人为本的姑息治疗方法。
本研究提供了关于以人为本的姑息治疗如何融入物理治疗师日常活动的具体描述。专门从事姑息治疗的物理治疗师帮助患者及其家属弥合现实生活与理想生活之间的差距，旨在最大限度地提高安全性、自主性和幸福感。所包括的具体例子可以用于理解物理治疗师对姑息治疗团队的贡献，并为未来的研究干预和结果提供信息。
