A growing body of studies indicate benefits of physiotherapy for patients in palliative care, for symptom relief and wellbeing. Though physiotherapists are increasingly acknowledged as important members of palliative care teams, they are still an underutilized source and not fully recognized. The aim of this study was to explore the variety of activities described by physiotherapists in addressing the needs and problems of patients and their families in specialized palliative care settings.
Using a free-listing approach, ten physiotherapists working in eight specialized palliative care settings in Sweden described as precisely and in as much detail as possible different activities in which patients and their families were included (directly or indirectly) during 10 days. The statements were entered into NVivo and analysed using qualitative content analysis. Statements containing more than one activity were categorized per activity.
In total, 264 statements, containing 504 varied activities, were coded into seven categories: Counteracting a declining physical function; Informing, guiding and educating; Observing, assessing and evaluating; Attending to signs and symptoms; Listening, talking with and understanding; Caring for basic needs; and Organizing, planning and coordinating. In practice, however, the activities were intrinsically interwoven. The activities showed how physiotherapists aimed, through care for the body, to address patients’ physical, psychological, social and existential needs, counteracting the decline in a patient’s physical function and wellbeing. The activities also revealed a great variation, in relation not only to what they did, but also to their holistic and inseparable nature with regard to why, how, when, where, with whom and for whom the activities were carried out, which points towards a well-adopted person-centred palliative care approach.
The study provides hands-on descriptions of how person-centred palliative care is integrated in physiotherapists’ everyday activities. Physiotherapists in specialized palliative care help patients and families to bridge the gap between their real and ideal everyday life with the aim to maximize security, autonomy and wellbeing. The concrete examples included can be used in understanding the contribution of physiotherapists to the palliative care team and inform future research interventions and outcomes.
Putt K, Faville KA, Lewis D, McAllister K, Pietro M, Radwan A. Role of physical therapy intervention in patients with life-threatening illnesses: a systematic review. Am J Hosp Palliat Care. 2015;34(2):186–96. CrossRef
Teunissen SCCM, Wesker W, Kruitwagen C, de Haes HCJM, Voest EE, de Graeff A. Symptom prevalence in patients with incurable cancer: a systematic review. J Pain Symptom Manag. 2007;34(1):94–104. CrossRef
Moens K, Higginson IJ, Harding R, Brearley S, Caraceni A, Cohen J, et al. Are there differences in the prevalence of palliative care-related problems in people living with advanced cancer and eight non-cancer conditions? A systematic review. J Pain Symptom Manag. 2014;48(4):660–77. CrossRef
Saunders C. Spiritual pain. J Palliat Care. 1988;4(3):29–32. PubMed
Cobbe S, Nugent K, Slattery S, Lynch M, Real S. A profile of hospice-at-home physiotherapy for community-dwelling palliative care patients. Int J Pall Nurs. 2013;19(1):39–45. CrossRef
Nelson LA, Hasson F, Kernohan WG. Exploring district nurses' reluctance to refer palliative care patients for physiotherapy. Int J Pall Nurs. 2012;18(4):163–70. CrossRef
Spill GR, Hlubocky FJ, Daugherty CK. Oncologists' and Physiatrists' attitudes regarding rehabilitation for patients with advanced cancer. PM&R. 2012;4(2):96–108. CrossRef
Guidelines for Good Practice. Association of Chartered Physiotherapists in Palliative Oncology. London: Chartered Society of Physiotherapy; 1993.
Ebel S, Langer K. The role of the physical therapist in hospice care. A J Hosp Pall Care. 1993;10(5):32–5. CrossRef
Marcant D, Rapin C-H. Role of the physiotherapist in palliative care. J Pain Symptom Manag. 1993;8(2):68–71. CrossRef
Mueller K, Decker I. Impact of physical therapy intervention on patient-centered outcomes in a community hospice. Top Geriatr Rehabil. 2011;27(1):2–9. CrossRef
Horne-Thompson A, Bramley R. The benefits of interdisciplinary practice in a palliative care setting: a music therapy and physiotherapy pilot project. Prog Palliat Care. 2011;19(6):304–8. CrossRef
Oldervoll LM, Loge JH, Paltiel H, Asp MB, Vidvei U, Wiken AN, et al. The effect of a physical exercise program in palliative care: a phase II study. J Pain Symptom Manag. 2006;31(5):421–30. CrossRef
Dahlin Y, Heiwe S. Patients’ experiences of physical therapy within palliative cancer care. J Palliat Care. 2009;25(1):12–20. PubMed
Gulde I, Oldervoll LM, Martin C. Palliative cancer patients' experience of physical activity. J Palliat Care. 2011;27(4):296–302. PubMed
Briggs A. Models for physical therapy practice in palliative medicine. Rehabil Oncol. 2000;18(2):18–9. 21
Fransson G. Annual report from the Swedish register of palliative care fiscal year 2015 (Årsrapport för Svenska Palliativregistret verksamhetsåret 2015). http://media.palliativ.se/2016/05/Årsrapport2016OrigGF.pdf. Accessed 24 Jan 2018. (In swedish).
Personal communication, Nordén M, Region Skåne, Lund, Sweden, 2018–01-08.
Chochinov HM, Hassard T, McClement S, Hack T, Kristjanson LJ, Harlos M, et al. The landscape of distress in the terminally ill. J Pain Symptom Manag. 2009;38(5):641–9. CrossRef
Taylor J, Simader R, Nieland P. Potential and possibility : rehabilitation at the end of life : physiotherapy in palliative care. Münich: Elsevier; 2013.
Radbruch L, Payne S. White paper on standards and norms for hospice and palliative care in Europe: part 1. Eur J Palliat Care. 2009;16:278—89.
Radbruch L, Payne S. White paper on standards and norms for hospice and palliative care in Europe: part 2. Eur J Palliat Care. 2010;17:22—33.
Central Ethical Review Board in Sweden https://www.epn.se/en/start/. Accessed 24 Jan 2018.
- Bridging gaps in everyday life – a free-listing approach to explore the variety of activities performed by physiotherapists in specialized palliative care
U. Olsson Möller
B. H. Rasmussen
- BioMed Central
Neu im Fachgebiet AINS
Meistgelesene Bücher aus dem Fachgebiet AINS
e.Med Kampagnen-Visual, Mail Icon II