Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada.
Faculty of Health Sciences, University of Southampton, Southampton, UK.
Physiother Theory Pract. 2020 Feb;36(2):307-315. doi: 10.1080/09593985.2018.1484535. Epub 2018 Jun 13.
: To identify the potential challenges and barriers to the implementation of Advanced Physiotherapy Practice (APP) in Ghana. : A basic interpretive qualitative study design was conducted, with a semi-structured focus group comprising eight physiotherapists and a one-to-one interview with the director of orthopedic surgery in the second largest hospital in Ghana. Participants were sampled purposefully to ensure they had a clear understanding of APP. Discussions were audio recorded, transcribed, coded and thematic analysis was performed. : Four key themes were identified as potential challenges to the implementation of APP in Ghana. Theme 1 Jurisdictional Disputes: Physiotherapists believed doctors will not accept the practice, while the doctor interviewed was willing to accept the practice. Theme 2: Management Support: Support from management was identified as a potential barrier to APP implementation due to workplace culture and liability. Theme 3 Change in Law and Policy: APP could be hindered if there is no legislative support and policies in place. Theme 4 Postgraduate Training: This was identified as key to the implementation of APP since there is no such level of training in Ghana. : Barriers to health-care programs are often not identified and addressed prior to their implementation in developing countries, leading to program failure. Addressing these four barriers and challenges could ensure the successful implementation of APP in Ghana. APP has the potential to improve access to rural health-care delivery and augment the shortage of health professionals in developing countries.
识别加纳实施高级物理治疗实践(APP)的潜在挑战和障碍。
采用基本解释性定性研究设计,由 8 名物理治疗师组成半结构式焦点小组,并对加纳第二大医院的骨科主任进行一对一访谈。参与者是有目的抽样的,以确保他们对 APP 有清晰的理解。讨论内容被录音、转录、编码和进行主题分析。
确定了加纳实施 APP 的四个主要挑战。主题 1:管辖权纠纷:物理治疗师认为医生不会接受该实践,而接受采访的医生愿意接受该实践。主题 2:管理支持:由于工作场所文化和责任,管理支持被认为是 APP 实施的潜在障碍。主题 3:法律和政策的变化:如果没有立法支持和相关政策,APP 可能会受到阻碍。主题 4:研究生培训:由于加纳没有这种培训水平,因此被确定为实施 APP 的关键。
在发展中国家实施医疗保健计划之前,往往没有识别和解决这些障碍,导致计划失败。解决这四个障碍和挑战,可以确保 APP 在加纳的成功实施。APP 有可能改善农村医疗服务的可及性,并弥补发展中国家卫生专业人员短缺的问题。