Premium
“I Was Really Pleasantly Surprised”: Firsthand Experience and Shifts in Physical Therapist Perceptions of Telephone‐Delivered Exercise Therapy for Knee Osteoarthritis–A Qualitative Study
Author(s) -
Lawford Belinda J.,
Delany Clare,
Bennell Kim L.,
Hinman Rana S.
Publication year - 2019
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.23618
Subject(s) - medicine , physical therapy , intervention (counseling) , focus group , qualitative research , randomized controlled trial , nursing , surgery , social science , marketing , sociology , business
Objective To explore physiotherapists’ perceptions before and after delivering exercise advice via telephone to patients with knee osteoarthritis ( OA ). Methods We performed a descriptive qualitative study (based on interpretivist methodology) embedded within a randomized controlled trial. Before and after providing exercise therapy to patients with knee OA , all 8 physiotherapists who were involved in the trial participated in semi‐structured interviews via telephone. Interviews were audio recorded, transcribed verbatim, and thematically analyzed. Results Prior to delivering the intervention, physiotherapists thought that the telephone should be used only for follow‐up rather than as the primary mode of providing care. They believed that telephone‐delivered care would be convenient and cost‐saving for patients, would provide increased opportunity for patient education, and also increase access to services, but that the lack of visual and physical contact with patients would be problematic. After delivering the intervention, physiotherapists reflected that telephone‐delivered care exceeded their expectations, noting positive patient outcomes including improved pain, function, and confidence. The focus on communication allowed more personal conversations with patients and shifted patient expectations of care away from manual therapies and toward self‐management. Numerous implementation considerations were identified, including the need for clinician training in communication skills, written resources for patients to supplement telephone calls, and careful deliberation of how to schedule telephone consultations during the usual in‐person consultations in the clinic. Conclusion Although physiotherapists were initially skeptical about the effectiveness of telephone‐delivered service models to patients with knee OA , perceptions shifted once they experienced delivery of care via this nontraditional method. Our findings suggest that firsthand experience may be necessary for physiotherapists to embrace new models of service delivery.