Conducting Qualitative Research in Physiotherapy: A methodological example

doi:10.1016/S0031-9406(05)65614-3

Physiotherapy

Volume 83, Issue 10, October 1997, Pages 547-552

https://doi.org/10.1016/S0031-9406(05)65614-3 Get rights and content

This paper provides an introduction to the subject of qualitative research and a practical approach to conducting this type of research through a detailed description of the design and methodology used in a specific study. The purpose of qualitative research is to describe and interpret issues or phenomena from the point of view of the individual or population being studied, and to generate new concepts and theories. The choice of methodology is directed by the questions being raised.

The purpose of the described study was to explore individual concepts of the experience of spinal cord injury. The method chosen for this study draws from phenomenology and is interpretive in nature. A preparatory framework and elements of design and methodology (selection of participants, pilot studies, data collection and analysis, and findings) used in the study are described in detail, and issues of ensuring the merit or trustworthiness of this type of research are discussed.

Physiotherapy research to date has been primarily conducted using a quantitative approach. The qualitative tradition offers physiotherapists an alternative research approach to questions arising from clinical practice, and is increasingly supported in the physiotherapy literature and included in academic programmes.

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Objectives Over the last decade there has been an increase in the number of physiotherapists working with an extended scope of practice in the orthopaedic outpatient clinic. There has been a growing feeling within the profession and the literature that these posts are more difficult than first perceived. The purpose of this qualitative study was to look at physiotherapists working in this setting and discover what has been their experience of the role and what recommendations they would make for future practitioners.
Design Qualitative, case study approach.
Setting Scottish National Health Service.
Participants Four physiotherapists working as extended scope practitioners.
Measures Data was collected using tape-recorded semi-structured interviews and investigated five main areas: training, responsibilities, support, satisfaction and recommendations.
Results The results suggested that success and satisfaction in post is dependent on the relationship with the consultant and the medical team; most extended scope practitioners experienced similar difficulties and had the same outstanding training needs.
Conclusions The overall impression from the findings was that although the job can be stressful it is also very satisfying. By ensuring a good relationship with the medical team, providing adequate ongoing training and support, many of the difficulties encountered by the participants could be minimised.
Qualitative research and evidence-based physiotherapy practice
2003, Physiotherapy
This paper discusses the potential contributions of qualitative research to evidence-based physiotherapy practice. Although qualitative research has been discussed previously in the physiotherapy literature, the relationship of qualitative inquiry to evidence-based practice has received little attention. We argue that qualitative research is a valuable source of clinical information that needs to be considered in formulations of best available evidence. If the aim of rehabilitation is to work collaboratively with patients to maximise their integration into the community, then we propose that the research agenda needs to address the lived experiences of patients within and outside the physiotherapy setting.
We begin by briefly reviewing the goals of physiotherapy practice, the historical sources of physiotherapy knowledge and the recent adoption of the evidence-based practice philosophy. We then discuss the relationship of qualitative methods to evidence and argue that qualitative research is under-represented in physiotherapy. Next we review the potential contributions of qualitative approaches to evidence-based physiotherapy practice and recent debates regarding synthesis of qualitative studies.
We conclude by calling for physiotherapists to collaborate in multi-disciplinary efforts to conduct, review, and disseminate high quality qualitative research.
Differences in the clinical reasoning process of expert and novice cardiorespiratory physiotherapists
2000, Physiotherapy
Through the process of clinical reasoning, physiotherapy practitioners critically evaluate their interventions in the management of patients. This qualitative investigation focused upon the thought processes of two groups of physiotherapists as they engaged in the consideration of a presented respiratory paper case scenario; identifying problems, possible diagnoses, and finally proposing a treatment plan. One group of 15 physiotherapists were designated ‘expert’ in their practice, whereas the second group of 15 were relatively inexperienced junior physiotherapists. The aim of the study was to investigate the differences in the clinical reasoning process of the novice versus the expert group.
After considering the presented paper case scenario, each therapist completed an open questionnaire. A corroborated content thematic analysis of the presenting data was performed. Through this analysis common themes were identified across the data, and differences presenting between novice and expert practitioners were explored.
A number of differences in the clinical reasoning process were identified between the novice and expert groups. It is postulated that the mechanisms for storage and retrieval of knowledge are more refined in the expert group. This in turn impacts upon practitioner problem-solving ability and hence clinical judgement. These findings support those of previous studies, which have not, however, included a consideration of the clinical reasoning process in the field of cardiorespiratory physiotherapy.
Clinically the results provide information on the different thought processes of novice and expert practitioners in the field of respiratory physiotherapy. This has implications for day-to-day management of physiotherapy staff and for the continuing professional development of practitioners.
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The physiotherapy profession has increasingly sought to demonstrate that its practice is based on sound scientific principles validated by rigorous research, in other words that its practice is evidence-based. This paper will assert that evidence-based practice requires not only carefully evaluated interventions judged through objective criteria but also input from patients in a systematic way that provides a foundation for patient-centred care. Consideration of both is essential if the best outcomes of physiotherapy intervention are to ensue. The merits of qualitative research are appraised as a means of adding the humanistic mission to result in best practice in physiotherapy.
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There is a variety of practices in medical humanities (Thow and Murray, 1991). Much of the literature claims that it has potential for a number of effects on health professionals' practice, both in undergraduate education and postgraduate training. However, research is needed to assess whether or not these potential effects occur.
The purpose of this qualitative study was to explore participants' perceptions of the effect of medical humanities on their practice: had there been an effect, and, if so, what was that effect? Semi-structured interviews were conducted with 15 participants, including health professionals and others. Five of this group were physiotherapists, all women. Five questions used to prompt discussion were developed with participants. Interviews lasted 20 minutes. Tapes were summarised and themes distilled.
Physiotherapists identified effects on their practice: increased care in communicating the purpose of treatment to patients, clearer views on controversial issues relevant to practice and wider insight into how patients perceive illness and themselves.
These physiotherapists reported enhanced skills which they related to medical humanities. They considered these gains would not have been achieved in their professional environments. According to these physiotherapists, the effect of medical humanities can be measured in terms of their personal and professional development.
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¹: Christine Carpenter MS BA DipPT is a senior instructor at the School of Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada.

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RESEARCH REPORTConducting Qualitative Research in Physiotherapy: A methodological example

Physiotherapy

Physiotherapy

Qualitative Research for Education: An introduction to theory and methods

‘The experience of spinal cord injury: The individual's perspective — Implications for rehabilitation practice’

Physical Therapy

‘Dialogue: The evolving culture of physiotherapy’

Physiotherapy Canada

‘The strengths and weaknesses of quantitative and qualitative research: What method for nursing?’

Journal of Advanced Nursing

‘The movement continuum theory of physical therapy’

Physiotherapy Canada

‘Psychological adaptation model for physical therapy practice’

Physical Therapy

‘Reviewing qualitative research: Proposed criteria for fairness and rigor’

Occupational Therapy Journal of Research

RESEARCH REPORT
Conducting Qualitative Research in Physiotherapy: A methodological example