Teng Bernadine, Rosbergen Ingrid C M, Gomersall Sjaan, Hatton Anna, Brauer Sandra G
School of Health and Rehabilitation Sciences, TheUniversity of Queensland, Brisbane, Australia.
Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore.
Disabil Rehabil. 2022 Sep;44(19):5530-5538. doi: 10.1080/09638288.2021.1938705. Epub 2021 Jun 29.
To seek physiotherapists' perspectives on patient adherence to exercise prescription for falls prevention/risk reduction in the Singapore setting.
Three focus groups with physiotherapists ( = 16) were conducted. An inductive thematic analysis was performed to identify main themes by four independent researchers.
Three main themes emerged: "it's about the patient," "delivery of the programme," and "carer/family support and facilitation." Physiotherapists believed that adherence was all about the patients' mindset and motivation, and they had to tailor interventions to optimise adherence to cater for patients as distinct characters, with different health/cultural beliefs and ability to prioritise time. Furthermore, physiotherapists reported better patient adherence when therapy goals referred to maintaining function rather than reducing falls. Families/carers can act as facilitators while providing practical and/emotional support further enhanced exercise adherence.
Awareness of the perspectives of physiotherapists in identifying and addressing patients' adherence to exercise may better equip researchers and healthcare providers in developing culturally relevant interventions that promote exercise adherence in Singapore. Certainly, adherence varies widely among patients receiving the same treatment. Analysis of predictive factors of non-adherence will assist to tailor intervention.Implications for rehabilitationPhysiotherapists believe the use of individualised approaches that adapt to patients and their health beliefs are critical for exercise adherence in older people in Singapore to prevent falls and falls risk.Adherence to exercise is multi-factorial: physiotherapists need to include attention to education, building rapport and facilitating practical and emotional family/carer support.Non-adherence is not merely a patient problem but is influenced by both clinicians and the healthcare system in Singapore/Southeast Asia.
探讨物理治疗师对新加坡患者坚持预防跌倒/降低跌倒风险运动处方的看法。
与物理治疗师开展了三个焦点小组（共16人）。由四名独立研究人员进行归纳主题分析以确定主要主题。
出现了三个主要主题：“关乎患者”、“方案实施”以及“护理人员/家庭支持与促进”。物理治疗师认为，坚持与否完全取决于患者的心态和动机，他们必须调整干预措施以优化坚持情况，从而满足具有不同性格、健康/文化信仰以及时间安排优先级能力的患者需求。此外，物理治疗师报告称，当治疗目标是维持功能而非减少跌倒时，患者的坚持情况更好。家庭/护理人员可以起到促进作用，同时提供实际和情感支持能进一步提高运动坚持性。
了解物理治疗师在识别和解决患者运动坚持问题方面的观点，可能会让研究人员和医疗服务提供者更好地制定与文化相关的干预措施，以促进新加坡患者的运动坚持性。当然，接受相同治疗的患者之间的坚持情况差异很大。分析不坚持的预测因素将有助于调整干预措施。对康复的启示
物理治疗师认为，采用适应患者及其健康信仰的个性化方法对于新加坡老年人预防跌倒和降低跌倒风险的运动坚持性至关重要。
物理治疗师需要关注教育、建立融洽关系以及促进家庭/护理人员提供实际和情感支持。
不坚持不仅仅是患者的问题，还受到新加坡/东南亚临床医生和医疗系统的影响。
