Boyd Jenna Kay, Rhodes Sarah, Gray Emily Anne
Health New Zealand, Te Whatu Ora, Waikato, Hamilton, New Zealand.
Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, Division of Health Sciences, University of Otago, Dunedin, New Zealand.
Physiother Res Int. 2025 Jan;30(1):e70020. doi: 10.1002/pri.70020.
As health systems come under increasing pressure, supporting patients to self-manage their own condition is becoming increasingly important. A shift towards a more holistic, person-centred approach to healthcare in the hospital setting, through enhancing self-management support (SMS), is required to empower patients to increase independence in managing their own conditions. The study aim was to explore how physiotherapists perceive and implement SMS with patients in hospital inpatient settings.
A qualitative study approach was taken using semi-structured interviews (n = 8). Physiotherapists with at least 6 months experience working in the inpatient hospital setting were invited to participate. Interview data were analysed using the General Inductive Approach.
Four themes were identified: (1) physiotherapists understanding and perceptions of implementation of SMS in the hospital, (2) SMS facilitates a person-centred and collaborative approach to healthcare, (3) SMS is beneficial to patients, physiotherapists, and the healthcare system, and (4) perceived challenges and potential solutions for SMS implementation.
Overall, physiotherapists value the use of self-management support in the hospital. SMS was implemented by partnering with patients, facilitating patients to problem solve and providing education so that patients could play an active role in decision making and independently participate in their rehabilitation. However, there appears to be scope to improve physiotherapists' knowledge of SMS to enable implementation of a wider range of SMS tools in clinical practice. A limitation of this study is that most participants were New Zealand European and, therefore, the findings are not generalisable to all physiotherapists working in New Zealand.
Physiotherapists perceive SMS to have a place in the inpatient hospital setting and can lead to better patient outcomes and reduce burden on the healthcare system. Enhancing physiotherapists' understanding of SMS and exploring other ways to implement SMS in hospital settings, may help to facilitate appropriate implementation.
随着卫生系统面临的压力不断增加，支持患者自我管理自身病情变得愈发重要。在医院环境中，需要通过加强自我管理支持（SMS），转向更全面、以患者为中心的医疗保健方法，以使患者在管理自身病情方面增强独立性。本研究的目的是探讨物理治疗师如何看待并在医院住院环境中对患者实施自我管理支持。
采用定性研究方法，进行半结构式访谈（n = 8）。邀请在住院医院环境中工作至少6个月的物理治疗师参与。访谈数据采用一般归纳法进行分析。
确定了四个主题：（1）物理治疗师对医院中自我管理支持实施的理解与看法；（2）自我管理支持促进以患者为中心的协作式医疗保健方法；（3）自我管理支持对患者、物理治疗师和医疗保健系统有益；（4）自我管理支持实施中察觉到的挑战及潜在解决方案。
总体而言，物理治疗师重视在医院中使用自我管理支持。通过与患者合作、促进患者解决问题并提供教育，实施自我管理支持，使患者能够在决策中发挥积极作用并独立参与康复。然而，似乎有必要提高物理治疗师对自我管理支持的认识，以便在临床实践中能够实施更广泛的自我管理支持工具。本研究的一个局限性是，大多数参与者是新西兰欧洲人，因此研究结果不能推广到在新西兰工作的所有物理治疗师。
物理治疗师认为自我管理支持在医院住院环境中有一席之地，并且可以带来更好的患者治疗效果，减轻医疗保健系统的负担。加强物理治疗师对自我管理支持的理解，并探索在医院环境中实施自我管理支持的其他方法，可能有助于促进其恰当实施。
