Pulmonary Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
Department of Rehabilitation-Physical Therapy, Radboud University Medical Center, Nijmegen, The Netherlands.
BMJ Open. 2023 Apr 19;13(4):e069368. doi: 10.1136/bmjopen-2022-069368.
The concept of 'complexity' is widely used by healthcare professionals in patient care. However, it is not completely understood. The inappropriate use and incorrect understanding of complexity lead to ambiguity for hospital-based physiotherapists in dealing with complex patients and work situations.
To develop an understanding of complexity for hospital-based physiotherapy from the perspective of physiotherapists themselves.
A grounded theory study was conducted using data from face-to-face, semi-structured interviews with purposive sampled hospital-based physiotherapists. The sampling was used to incorporate variety in hospital work experience, field of expertise and gender. The interviews were conducted in three different types of Dutch hospitals. A conceptual model and grounded theory were constructed after open, axial and selective coding.
Twenty-four hospital-based physiotherapists were interviewed. Two core themes emerged from the data: 'puzzle-solving' and 'reflecting on decisions'. The third theme-'relationship between learning, adapting and complexity'-describes how hospital-based physiotherapists' perceptions of complexity change over time. Complexity as a construct was interpreted as the balance between context and patient-related factors on the one hand and therapist-related factors on the other.
Hospital-based physiotherapists encounter complexity during performing job-related activities and decision-making. Complexity depends on balancing context and patient-related factors and therapist-related factors. In hospital-based physiotherapy, it was perceived as challenging yet meaningful. Complexity contributes to becoming more competent and, as such, a balance between complex and non-complex activities should be sought for hospital-based physiotherapists.
“复杂性”的概念在医疗保健专业人员的患者护理中被广泛使用。然而，它并没有被完全理解。复杂性的不当使用和错误理解导致医院物理治疗师在处理复杂患者和工作情况时感到困惑。
从物理治疗师自身的角度来理解医院物理治疗中的复杂性。
采用扎根理论研究方法，对来自荷兰三家不同类型医院的、具有不同医院工作经验、专业领域和性别特点的 24 名医院物理治疗师进行了面对面的半结构化访谈。在开放性、轴向和选择性编码后，构建了概念模型和扎根理论。
共对 24 名医院物理治疗师进行了访谈。数据中出现了两个核心主题：“解决问题”和“反思决策”。第三个主题“学习、适应和复杂性之间的关系”描述了医院物理治疗师对复杂性的看法随时间的变化。作为一个结构，复杂性被解释为一方面是环境和患者相关因素与另一方面治疗师相关因素之间的平衡。
医院物理治疗师在进行与工作相关的活动和决策时会遇到复杂性。复杂性取决于平衡环境和患者相关因素以及治疗师相关因素。在医院物理治疗中，它被认为是具有挑战性但又有意义的。复杂性有助于提高能力，因此，医院物理治疗师应寻求复杂活动和非复杂活动之间的平衡。
