Advanced musculoskeletal physiotherapy practice: The patient journey and experience.


Journal

Musculoskeletal science & practice
ISSN: 2468-7812
Titre abrégé: Musculoskelet Sci Pract
Pays: Netherlands
ID NLM: 101692753

Informations de publication

Date de publication:
02 2020
Historique:
received: 19 08 2019
revised: 16 10 2019
accepted: 28 10 2019
pubmed: 16 11 2019
medline: 30 6 2021
entrez: 16 11 2019
Statut: ppublish

Résumé

As many patients referred to orthopaedic and rheumatology services do not require medical or surgical interventions, advanced practice physiotherapists (APPs) have been introduced into hospital services to triage the care of these patients. Patient perspectives are critical to review the acceptance of this model of care and potential for expansion into primary care. This study aimed to explore the clinical journeys, and the experiences and perceptions of patients attending APP services. Semi-structured interviews (n = 10) were conducted with patients across two hospital sites, with narrative data subjected to a thematic analysis. MSK journeys were mapped via medical chart and interview data, with surveys collecting demographics. Patient journeys involved multiple contact points and some duplication in MSK health services. Overall, experiences of the APP service were positive, with faster access into the hospital system and patients valued the interpersonal and professional skills of the APP. Having already attended a physiotherapist, some patients did have a preconception of what the APP could offer them. However, initial concerns were mitigated following the APP appointment, as the APP had extensive MSK knowledge. Hospitals remained the preferred location for MSK appointments due to availability of diagnostics and 'specialists', and close proximity of the doctor. Patients were positive about the new MSK APP service and benefits related to shorter wait times and seeing a specialist who listened and involved them in their management. However, a cultural shift regarding patient perceptions of the 'specialists' in hospitals and the role of a physiotherapist is required.

Sections du résumé

BACKGROUND
As many patients referred to orthopaedic and rheumatology services do not require medical or surgical interventions, advanced practice physiotherapists (APPs) have been introduced into hospital services to triage the care of these patients. Patient perspectives are critical to review the acceptance of this model of care and potential for expansion into primary care. This study aimed to explore the clinical journeys, and the experiences and perceptions of patients attending APP services.
METHOD
Semi-structured interviews (n = 10) were conducted with patients across two hospital sites, with narrative data subjected to a thematic analysis. MSK journeys were mapped via medical chart and interview data, with surveys collecting demographics.
RESULTS
Patient journeys involved multiple contact points and some duplication in MSK health services. Overall, experiences of the APP service were positive, with faster access into the hospital system and patients valued the interpersonal and professional skills of the APP. Having already attended a physiotherapist, some patients did have a preconception of what the APP could offer them. However, initial concerns were mitigated following the APP appointment, as the APP had extensive MSK knowledge. Hospitals remained the preferred location for MSK appointments due to availability of diagnostics and 'specialists', and close proximity of the doctor.
CONCLUSION
Patients were positive about the new MSK APP service and benefits related to shorter wait times and seeing a specialist who listened and involved them in their management. However, a cultural shift regarding patient perceptions of the 'specialists' in hospitals and the role of a physiotherapist is required.

Identifiants

pubmed: 31731056
pii: S2468-7812(19)30394-7
doi: 10.1016/j.msksp.2019.102077
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

102077

Informations de copyright

Copyright © 2019 Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest None to declare.

Auteurs

Orna Fennelly (O)

School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin, Ireland. Electronic address: orna.fennelly@ucdconnect.ie.

Catherine Blake (C)

School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin, Ireland. Electronic address: c.blake@ucd.ie.

Oliver FitzGerald (O)

Department of Rheumatology, St. Vincent's University Hospital, Dublin, Ireland; Conway Institute, University College Dublin, Belfield, Dublin, Ireland. Electronic address: oliver.fitzgerald@ucd.ie.

Aoife Caffrey (A)

Bone and Joint Clinic, St. Vincent's University Hospital, Dublin, Ireland. Electronic address: acaffrey@svhg.ie.

Laura Fletcher (L)

Physiotherapy Department, University Hospital Waterford, Waterford, Ireland. Electronic address: LauraF.Fletcher@hse.ie.

Keith Smart (K)

Bone and Joint Clinic, St. Vincent's University Hospital, Dublin, Ireland. Electronic address: KSmart@svhg.ie.

Siobhan Corcoran (S)

Physiotherapy Department, University Hospital Waterford, Waterford, Ireland. Electronic address: siobhanm.corcoran@hse.ie.

Éidín Ní Shé (ÉN)

School of Nursing and Health Systems, University College Dublin, Belfield, Dublin, Ireland. Electronic address: eidin.nishe@ucd.ie.

Sarah Casserley-Feeney (S)

Physiotherapy Department, Sligo University Hospital, Sligo, Ireland. Electronic address: Sarah.Casserley@hse.ie.

François Desmeules (F)

School of Rehabilitation, University of Montreal, Canada. Electronic address: f.desmeules@umontreal.ca.

Caitriona Cunningham (C)

School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin, Ireland. Electronic address: caitriona.g.cunningham@ucd.ie.

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Classifications MeSH