Lin Marisa S, Martin Ginis Kathleen A, Le Cornu Levett Catherine, McBride Christopher B, Colistro Regina, Plashkes Tova, Bass Andrea, Thorson Teri, Clarkson Ryan, Bitz Rod, Walden Kristen, Kell-Cattrysse Cassandra, Ma Jasmin K
School of Kinesiology, University of British Columbia, Vancouver, Canada.
Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
Physiother Theory Pract. 2025 Sep;41(9):1901-1913. doi: 10.1080/09593985.2025.2484610. Epub 2025 Apr 2.
A large decrease in physical activity (PA) is typically observed among people with spinal cord injury (SCI) upon discharge from in-hospital rehabilitation. Physiotherapists and SCI peers are well-positioned to intervene at this critical timepoint; however,the implementation of coordinated PA interventions between these two groups have yet to be studied.
To identify barriers and facilitators that affect the implementation of coordinated PA counseling among physiotherapists and SCI peers during the transition from in-hospital rehabilitation to the community.
Semi-structured interviews were conducted with nine physiotherapists and two SCI peer coaches, using an interview guide informed by the Theoretical Domains Framework (TDF). Interviews were transcribed and coded deductively onto the TDF with themes and subthemes generated by inductive content analysis.
The most salient TDF domains were social influences, environmental context and resources, and skills. Specifically, participants identified challenges such as addressing patient barriers and continual staff onboarding. Facilitators included the availability of peer coaches with lived experience, support from champions of the PA counseling intervention, group training sessions for physiotherapists and SCI peer coaches, and an adaptable PA counseling form as a conversation guide.
Successful coordination of services provided during the transition from in-hospital rehabilitation to the community may be strengthened by 1) providing resources and training that guide both content and delivery of PA counseling and 2) a referral system that leverages the strengths of both physiotherapists and peer support.
脊髓损伤（SCI）患者在出院后从医院康复过渡到社区的过程中，通常会出现身体活动（PA）大幅下降的情况。物理治疗师和脊髓损伤患者同伴处于在这个关键时间点进行干预的有利位置；然而，这两组之间协调的身体活动干预措施的实施情况尚未得到研究。
确定在从医院康复过渡到社区的过程中，影响物理治疗师和脊髓损伤患者同伴之间协调进行身体活动咨询实施的障碍和促进因素。
使用由理论领域框架（TDF）指导的访谈指南，对9名物理治疗师和2名脊髓损伤患者同伴教练进行了半结构化访谈。访谈内容被转录，并根据归纳内容分析产生的主题和子主题，演绎编码到TDF上。
最突出的TDF领域是社会影响、环境背景和资源以及技能。具体而言，参与者确定了一些挑战，如解决患者障碍和持续的员工入职培训。促进因素包括有实际生活经验的同伴教练的可用性、身体活动咨询干预倡导者的支持、针对物理治疗师和脊髓损伤患者同伴教练的小组培训课程，以及一种可适应的身体活动咨询表格作为对话指南。
在从医院康复过渡到社区的过程中，成功协调所提供的服务可以通过以下方式得到加强：1）提供指导身体活动咨询内容和实施的资源和培训；2）利用物理治疗师和同伴支持优势的转诊系统。
