Physiotherapy Programme, UCL Great Ormond Street Institute of Child Health, London, UK.
Centre for Research in Public Health and Community Care, University of Hertfordshire, Hatfield, UK.
Clin Rehabil. 2019 Dec;33(12):1963-1977. doi: 10.1177/0269215519868797. Epub 2019 Aug 13.
Many patients do not meet recommended levels of therapy-based exercise. This review aims to explore how adult patients view being prescribed therapy-based exercise, the information/education they are given and receive and if/how they independently practise and adhere.
A qualitative systematic review conducted using an ethnographic approach and in accordance with the PRISMA statement.
PubMed, CINAHL, SCOPUS and EMBASE databases (01 January 2000-31 December 2018).
Qualitative studies with a focus on engagement/adherence with therapy-based exercise were included. Data extraction and quality appraisal were undertaken by two reviewers. Results were discussed and data synthesized.
A total of 20,294 titles were screened, with data extracted from 39 full texts and data from 18 papers used to construct three themes. 'The Guidance received' suggests that the type of delivery desired to support and sustain engagement was context-dependent and individually situated. 'The Therapist as teacher' advocates that patients see independent therapy-based exercise as a shared activity and value caring, kind and professional qualities in their therapist. 'The Person as learner' proposes that when having to engage with and practise therapy-based exercise because of ill-health, patients often see themselves as new learners who experience fear and uncertainty about what to do. Patients may have unacknowledged ambivalences about learning that impact on engagement and persistence.
The quality of the interaction between therapists and patients appears integral to patients engaging with, and sustaining practice of, rehabilitation programmes. Programmes need to be individualized, and health care professionals need to take patients' previous experiences and ambivalences in motivation and empowerment into account.
许多患者未达到基于治疗的运动的推荐治疗水平。本综述旨在探讨成年患者对基于治疗的运动处方的看法、他们获得的信息/教育，以及他们是否以及如何独立进行和坚持练习。
采用人种学方法进行的定性系统综述，并符合 PRISMA 声明。
PubMed、CINAHL、SCOPUS 和 EMBASE 数据库（2000 年 1 月 1 日至 2018 年 12 月 31 日）。
纳入了以基于治疗的运动的参与/坚持为重点的定性研究。两名评审员进行了数据提取和质量评估。对结果进行了讨论和数据综合。
共筛选出 20,294 个标题，从 39 篇全文中提取数据，并从 18 篇论文中提取数据用于构建三个主题。“所接受的指导”表明，支持和维持参与的所需传递类型取决于背景和个体情况。“治疗师作为老师”主张患者将独立的基于治疗的运动视为一种共同的活动，并重视治疗师的关怀、善良和专业素质。“学习者作为个体”提出，当由于健康状况不佳而不得不参与和练习基于治疗的运动时，患者通常将自己视为新的学习者，对要做什么感到恐惧和不确定。患者对学习的未被认识到的矛盾心理可能会影响参与和坚持。
治疗师与患者之间互动的质量似乎对患者参与和维持康复计划至关重要。方案需要个体化，卫生保健专业人员需要考虑患者以前的经验以及在动机和赋权方面的矛盾心理。
