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How do portuguese novice physiotherapists practice patient education?
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Abstract(s)
Introdução: Entre os adultos em idade ativa, as condições músculo-esqueléticas
são a principal causa de incapacidade. A educação centrada na pessoa é
recomendada para restaurar e manter a função, melhorar a participação, e fornecer
um plano de gestão da condição. Fisioterapeutas recém-licenciados reportam
maiores dificuldades e barreiras, em comparação com fisioterapeutas experientes
na educação do utente. Contudo, pouco se sabe sobre a forma como implementam
a educação enquanto modalidade terapêutica.
Objetivos: Este estudo teve como objetivo explorar os modelos que estão na base
da prática de educação, enquanto modalidade terapêutica implementada por
fisioterapeutas recém-licenciados portugueses, no contexto músculo-esquelético.
Metodologia: Foi realizado um estudo etnográfico, que integrou observações de
vídeos de sessões de tratamento entre fisioterapeutas recém-licenciados e utentes
com condições musculoesqueléticas, com foco na educação do utente, juntamente
com entrevistas com elicitação por vídeo. Foi desenvolvido e aplicado um guião de
observação e um guião de entrevistas semiestruturadas para a recolha de dados.
A análise dos dados foi realizada através de uma análise de conteúdo dedutiva e
um esquema de codificação. Várias estratégias foram implementadas para garantir
o rigor da análise, incluindo member check, triangulação dos investigadores, um
diário reflexivo e um audit trail.
Resultados: Oito participantes (≤ 5 anos de experiência profissional) foram
observados e, posteriormente, entrevistados. As práticas dos participantes foram
categorizadas em três tipos: tipo 1 – atividade-passividade; tipo 2 – orientaçãocooperação; e tipo 3 – participação mútua. A maioria dos participantes demonstrou
características de mais do que um tipo de prática. No entanto, foi possível identificar
um tipo dominante para cada participante, que foi consistente entre vídeos e
entrevistas.
Conclusão: Este estudo sugere que a prática de educação, enquanto modalidade
terapêutica, aplicada por fisioterapeutas recém-licenciados portugueses, na
intervenção com utentes com condições músculo-esqueléticas, tende a situar-se
entre os tipos atividade-passividade e participação mútua. Os participantes
demonstraram dificuldades na participação mútua, com mais da metade
categorizados, principalmente, como envolvidos em práticas de educação
centradas no fisioterapeuta.
Background: Among occupationally active adults, musculoskeletal disorders are the leading cause of disability. Person-centred education is recommended to restore and maintain function, improve participation, and provide a management plan. Novice physiotherapists report greater difficulties and face more barriers compared to experienced physiotherapists in delivering patient education. However, little is known about how they practice patient education. Objectives: This study aimed to explore the models underpinning the practices of Portuguese novice physiotherapists regarding patient education in the musculoskeletal clinical setting. Methods: An ethnographic study was conducted, integrating observations of video recordings of treatment sessions between novice physiotherapists and patients with musculoskeletal conditions, with a focus on patient education, along with video elicitation interviews. An observation guide and a semi-structured interview schedule were developed and applied for data collection. Data analysis was performed using deductive content analysis and a coding scheme. Several strategies were implemented to ensure the rigour of the analysis, including member check, investigator triangulation, a reflexive diary and an audit trail. Results: Eight participants (≤ 5 years of professional experience) were observed and subsequently interviewed. The participants’ practices were categorised into three types: type 1 – activity-passivity; type 2 – guidance-cooperation; and, type 3 – mutual participation. Most participants demonstrated characteristics of more than one practice type. Nevertheless, a dominant type could be identified for each participant, which was generally consistent across both videos and interviews. Conclusion: The current study suggests that Portuguese novice physiotherapists’ practice of patient education tends to fall between the activity-passivity and mutual participation types. Participants faced challenges in achieving mutual participation, with more than half primarily categorised as engaging in physiotherapist-centred education practices.
Background: Among occupationally active adults, musculoskeletal disorders are the leading cause of disability. Person-centred education is recommended to restore and maintain function, improve participation, and provide a management plan. Novice physiotherapists report greater difficulties and face more barriers compared to experienced physiotherapists in delivering patient education. However, little is known about how they practice patient education. Objectives: This study aimed to explore the models underpinning the practices of Portuguese novice physiotherapists regarding patient education in the musculoskeletal clinical setting. Methods: An ethnographic study was conducted, integrating observations of video recordings of treatment sessions between novice physiotherapists and patients with musculoskeletal conditions, with a focus on patient education, along with video elicitation interviews. An observation guide and a semi-structured interview schedule were developed and applied for data collection. Data analysis was performed using deductive content analysis and a coding scheme. Several strategies were implemented to ensure the rigour of the analysis, including member check, investigator triangulation, a reflexive diary and an audit trail. Results: Eight participants (≤ 5 years of professional experience) were observed and subsequently interviewed. The participants’ practices were categorised into three types: type 1 – activity-passivity; type 2 – guidance-cooperation; and, type 3 – mutual participation. Most participants demonstrated characteristics of more than one practice type. Nevertheless, a dominant type could be identified for each participant, which was generally consistent across both videos and interviews. Conclusion: The current study suggests that Portuguese novice physiotherapists’ practice of patient education tends to fall between the activity-passivity and mutual participation types. Participants faced challenges in achieving mutual participation, with more than half primarily categorised as engaging in physiotherapist-centred education practices.
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Keywords
Educação do utente Educação centrada na pessoa Fisioterapeutas recém-licenciados Investigação qualitativa Etnografia Entrevistas com elicitação por vídeo Patient education Person-centred education Novice physiotherapists Qualitative research Ethnography Video elicitation interviews