Charumbira Maria Y, Berner Karina, Louw Quinette
Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, P.O. Box 241, Cape town, 8000, South Africa.
BMC Health Serv Res. 2021 Apr 13;21(1):333. doi: 10.1186/s12913-021-06343-1.
Recent research has indicated a seemingly increased propensity for both falls and accelerated bone loss in people living with HIV (PLWH). Physiotherapists play a crucial role in optimising function and quality of life of PLWH through prevention of falls and reducing the harm that results.
This study aimed to explore physiotherapists' awareness of falls risk and accelerated bone demineralisation in PLWH and their perceptions of current falls prevention strategies in the care of PLWH in selected regions of sub-Saharan Africa.
An exploratory descriptive qualitative research method was employed to explore physiotherapists' perceptions and experiences regarding bone health and falls in PLWH. In-depth semi-structured telephonic interviews were used to collect data from 21 physiotherapists working in primary HIV care. Transcribed interview data were coded in Atlas.ti.8® and analysed using inductive thematic analysis.
The primary study revealed a lack of awareness by physiotherapists of falls risk and bone demineralisation in PLWH. As such, physiotherapists did not link falls or fractures to HIV or antiretroviral therapy (ART) when they did observe such events during their general patient assessments. However, in retrospect, some physiotherapists were able to recognise risk factors linked to falls in those with HIV. Current services for falls prevention, as perceived by the physiotherapists, were sub-optimal.
Physiotherapists may need to be more aware of the potential risk of falls and bone demineralisation in PLWH and routinely assess for these phenomena in both older and younger PLWH.
近期研究表明，感染人类免疫缺陷病毒（HIV）的患者（PLWH）似乎更容易跌倒，且骨质流失加速。物理治疗师在预防跌倒及减少由此造成的伤害，从而优化PLWH的功能和生活质量方面发挥着关键作用。
本研究旨在探讨物理治疗师对PLWH跌倒风险和骨质加速脱矿的认识，以及他们对撒哈拉以南非洲选定地区PLWH护理中当前跌倒预防策略的看法。
采用探索性描述性定性研究方法，以探究物理治疗师对PLWH骨骼健康和跌倒的看法及经验。通过深入的半结构化电话访谈，收集了21名从事初级HIV护理工作的物理治疗师的数据。转录后的访谈数据在Atlas.ti.8®中进行编码，并采用归纳主题分析法进行分析。
初步研究发现，物理治疗师对PLWH的跌倒风险和骨质脱矿缺乏认识。因此，在对普通患者进行评估时，即便观察到此类情况，物理治疗师也未将跌倒或骨折与HIV或抗逆转录病毒疗法（ART）联系起来。然而，事后回顾时，一些物理治疗师能够识别出与HIV感染者跌倒相关的风险因素。物理治疗师认为，目前的跌倒预防服务并不理想。
物理治疗师可能需要更加了解PLWH跌倒和骨质脱矿的潜在风险，并对老年和年轻的PLWH定期评估这些现象。
