Wilson Christopher M, Stiller Christine H, Doherty Deborah J, Thompson Kristine A, Smith Alexander B, Turczynski Kelly L
Human Movement Science department - Physical Therapy Program, Oakland University, Rochester, Michigan, USA
Physical and Occupational Therapy, Beaumont Health, Troy, Michigan, USA.
BMJ Support Palliat Care. 2022 May;12(e1):e59-e67. doi: 10.1136/bmjspcare-2019-002161. Epub 2020 Feb 20.
The purpose of this study was to explore the perceptions and experiences of physical therapists (PTs) regarding their role in palliative care (PC) when practising in nations with advanced integration of PC into mainstream healthcare.
This qualitative study included an electronic demographic survey and semistructured interview. Data analysis included descriptive statistics for demographics and the constant comparative method for interview results.
Thirteen PTs from eight nations identified four categories of roles and responsibilities: (1) working with patients and families, (2) being an interdisciplinary team (IDT) member, (3) professional responsibilities beyond direct patient care and (4) factors influencing the role of PTs in PC. Concepts identified were (increased family involvement, emphasis on psychosocial aspects and differences in care philosophy), (accommodating changes in patient status, increasing awareness of PTs' role in varying disease states and working with the IDT) and (perceptions of PTs/others regarding PTs' role in PC and professional responsibilities of the PT in PC).
Based on participant responses, a previously published conceptual framework by Wilson in 2017 was updated and included an increased emphasis on patient wishes and dignity, treating breathlessness, patient advocacy within their family and use of technology and networking. Within PC, PTs play a key role on the IDT and can improve quality of life; however, multiple barriers exist to providing PT care within PC. Further advocacy is needed from PTs and professional organisations to integrate these services.
本研究的目的是探讨在姑息治疗（PC）已深度融入主流医疗保健的国家中执业的物理治疗师（PT）对其在姑息治疗中角色的认知和体验。
这项定性研究包括电子人口统计学调查和半结构化访谈。数据分析包括人口统计学的描述性统计和访谈结果的持续比较法。
来自八个国家的13名物理治疗师确定了四类角色和职责：（1）与患者及其家属合作；（2）成为跨学科团队（IDT）成员；（3）直接患者护理之外的专业职责；（4）影响物理治疗师在姑息治疗中角色的因素。确定的概念包括（增加家庭参与度、强调心理社会方面以及护理理念的差异）、（适应患者状况的变化、提高物理治疗师在不同疾病状态下角色的认知以及与跨学科团队合作）和（物理治疗师/其他人对物理治疗师在姑息治疗中角色的认知以及物理治疗师在姑息治疗中的专业职责）。
根据参与者的回答，2017年威尔逊先前发表的概念框架得到了更新，更加注重患者意愿和尊严、治疗呼吸困难、在患者家庭中为患者争取权益以及技术和网络的应用。在姑息治疗中，物理治疗师在跨学科团队中发挥着关键作用，能够提高生活质量；然而，在姑息治疗中提供物理治疗服务存在多种障碍。物理治疗师和专业组织需要进一步倡导整合这些服务。
