Department of Physiotherapy, NHS Greater Glasgow & Clyde, Glasgow, UK.
General Practice & Primary Care, School of Health & Wellbeing, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow G12 8TB, UK.
Physiotherapy. 2024 Sep;124:1-8. doi: 10.1016/j.physio.2024.04.348. Epub 2024 Apr 25.
Physical inactivity is estimated to cost the UK National Health Service over £7.4 billion per year. Healthcare practitioners have a key role in supporting increases in physical activity (PA) levels, including referring to exercise referral schemes. To date, there has been little research into practitioner perspectives on referrals to exercise schemes.
To explore the views and experiences of General Practitioners (GPs) and physiotherapists in relation to factors which influence referral and adherence to exercise referral schemes.
Qualitative study of primary care-based practitioners in Glasgow, UK.
Semi-structured interviews were conducted with 14 practitioners (seven GPs and seven physiotherapists). Interviews were recorded and analysed thematically.
Four themes are presented. Firstly, all people, including healthcare practitioners, bring inherent biases which are influenced by their background, experiences and worldviews to a consultation which impact their approach to PA promotion. Secondly, clinical time pressures are a major barrier to effective PA promotion. Thirdly, patient-led, compassionate care which seeks to fully understand a patient is the most vital component of behaviour change, with suggestions that promoting peer support and the use of personal anecdotes to normalise vulnerabilities might be helpful. Lastly, providing ongoing support for change was felt to be beneficial to PA promotion. This is often accessed through exercise referral schemes and improved by better collaboration between exercise providers and referring practitioners.
Practitioners believed exercise referrals could be improved with more targeted training in behaviour change facilitation, support for multidisciplinary working, and enhanced communication between the programmes and referrers. Additionally, supporting behaviour change requires time for compassionate care and fully understanding patients' motivations and beliefs. Lack of time was felt to be the greatest current barrier to effective PA promotion. CONTRIBUTION OF THE PAPER.
据估计，英国国民保健制度因身体活动不足每年损失超过 74 亿英镑。医疗保健从业者在支持身体活动（PA）水平提高方面发挥着关键作用，包括向运动推荐计划转介。迄今为止，关于从业者对运动计划转介的看法的研究甚少。
探讨全科医生（GP）和物理治疗师对影响转介和坚持运动推荐计划的因素的看法和经验。
设计、地点和参与者：英国格拉斯哥以初级保健为基础的从业者的定性研究。
对 14 名从业者（7 名全科医生和 7 名物理治疗师）进行半结构化访谈。对访谈进行录音和主题分析。
提出了四个主题。首先，包括医疗保健从业者在内的所有人都带有固有偏见，这些偏见受到他们的背景、经验和世界观的影响，从而影响他们对 PA 促进的方法。其次，临床时间压力是有效促进 PA 的主要障碍。第三，以患者为中心、富有同情心的护理，旨在全面了解患者，是行为改变的最关键组成部分，并提出促进同伴支持和使用个人轶事来使脆弱性正常化可能会有所帮助。最后，为改变提供持续支持被认为对促进 PA 有益。这通常通过运动推荐计划获得，并通过运动提供者和推荐从业者之间更好的合作得到改善。
从业者认为，通过更有针对性的行为改变促进培训、支持多学科工作以及增强计划与推荐者之间的沟通，可以改善运动推荐。此外，支持行为改变需要时间进行富有同情心的护理，并充分了解患者的动机和信念。缺乏时间被认为是目前有效促进 PA 的最大障碍。
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