Monaiwa Keamogetswe, Yazbek Mariatha, Magida Nontembiso
Department of Physiotherapy, Faculty of Healthcare Sciences, University of Pretoria, Pretoria, South Africa.
Department of Nursing Science, Faculty of Healthcare Science, University of Pretoria, Pretoria, South Africa.
S Afr J Physiother. 2025 Jun 11;81(1):2163. doi: 10.4102/sajp.v81i1.2163. eCollection 2025.
Polytrauma can be life altering, requiring a holistic approach to reach the highest functional level. Physiotherapists prescribe home exercise programmes (HEPs) to prevent complications associated with immobility. Adherence to HEPs is crucial, yet factors influencing non-adherence remain underexplored.
Our study explored patients with polytrauma perspectives on adherence to prescribed HEPs.
A qualitative exploratory, descriptive design was used to recruit participants purposively from a rehabilitation unit in Tshwane district, South Africa. Participants diagnosed with polytrauma, aged 18 years or older, and prescribed a HEP were included, while those with cognitive impairments or language barriers were excluded. Consent was obtained while hospitalised, and participants were contacted 3 months post-discharge for telephonic semistructured interviews lasting 30-45 min. Ethical clearance (reference number: 595/2022) and institutional permission were granted. Interviews were audio-recorded and conducted until data were saturated. Data were verbatim transcribed and analysed thematically to identify key themes and sub-themes.
Thirteen participants (8 male and 5 female participants) with a mean age of 43.77 (standard deviation = 10.45) were interviewed. The four major themes were physical, psycho-cognitive, social and environmental factors. Adherence barriers were more significant than facilitators. The most frequently reported facilitator was family support, whereas the most commonly reported barrier was pain.
Polytrauma patients identified more barriers than facilitators affecting HEP adherence. Pain significantly hindered adherence, while family support was a key enabler.
Physiotherapists should work collaboratively with patients to develop inclusive HEPs that consider their demographic, social, psychological, physical and environmental context.
多发伤可能会改变生活，需要采取整体方法以达到最高功能水平。物理治疗师会开出家庭锻炼计划（HEP）以预防与不动相关的并发症。坚持HEP至关重要，但影响不坚持的因素仍未得到充分探索。
我们的研究探讨了多发伤患者对坚持规定的HEP的看法。
采用定性探索性描述性设计，从南非茨瓦内地区的一个康复单位有目的地招募参与者。纳入诊断为多发伤、年龄18岁及以上且被开出HEP的参与者，排除有认知障碍或语言障碍的参与者。在住院期间获得同意，并在出院后3个月联系参与者进行持续30 - 45分钟的电话半结构化访谈。获得了伦理批准（参考编号：595/2022）和机构许可。访谈进行录音，直至数据饱和。数据逐字转录并进行主题分析，以确定关键主题和子主题。
采访了13名参与者（8名男性和5名女性参与者），平均年龄为43.77岁（标准差 = 10.45）。四个主要主题是身体、心理认知、社会和环境因素。坚持的障碍比促进因素更显著。最常报告的促进因素是家庭支持，而最常见的障碍是疼痛。
多发伤患者发现影响HEP坚持的障碍比促进因素更多。疼痛显著阻碍了坚持，而家庭支持是关键的促成因素。
物理治疗师应与患者合作制定包容性的HEP，考虑他们的人口统计学、社会、心理、身体和环境背景。
