Teo, PL, Bennell, KL, Lawford, BJ, Egerton, T, Dziedzic, KS and Hinman, RS (2020) Physiotherapists may improve management of knee osteoarthritis through greater psychosocial focus, being proactive with advice, and offering longer-term reviews: a qualitative study. Journal of Physiotherapy. ISSN 0004-9514

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QUESTIONS: What are the experiences of physiotherapists delivering care for people with knee osteoarthritis? How do these experiences align with the national Clinical Care Standard? DESIGN: A qualitative study using individual interviews. PARTICIPANTS: Twenty-two Australian physiotherapists (mean age 34 years, 50% female) with experience in providing care for people with knee osteoarthritis. METHODS: Physiotherapists participated in semi-structured individual telephone interviews. Questions were informed by seven quality statements from the national Knee Osteoarthritis Clinical Care Standard. Thematic analysis was undertaken, with themes/subthemes inductively derived. Interview data were also deductively analysed according to the Clinical Care Standard. RESULTS: Five themes emerged. First, physiotherapists focused on biomedical assessment with little psychosocial consideration. They managed 'mechanical' aspects of knee osteoarthritis, aiming to restore functional ability. Second, physiotherapists' perceived their role as primarily providing goal-orientated personalised exercise via short-term episodic care. Knee surgery was considered a last option, but physiotherapists 'prepped' patients who decided on surgery. Third, clinical challenges included patient comorbidity, unsatisfactory patient adherence and a patient's desire for a 'quick fix'. The other two themes were: physiotherapists described a mismatch between what they know and what they do regarding imaging, weight management and manual therapy; and physiotherapists viewed weight loss, medication and surgical advice as outside of their professional role. CONCLUSION: Physiotherapists' reported experiences of delivering care for people with knee osteoarthritis were mostly consistent with the quality care standard. Care may be improved by increasing the focus on psychosocial aspects of care, offering longer-term reviews, and being more proactive with advice and/or referral regarding weight loss, pain medications and knee surgery. By describing the potential benefits and harms of common osteoarthritis medications and surgical interventions, physiotherapists will ensure that their patients are fully informed about all their treatment options.

Item Type: Article
Additional Information: 1836-9553/© 2020 Australian Physiotherapy Association. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).
Uncontrolled Keywords: Qualitative research, Physical therapy, Knee osteoarthritis, Quality of care, Clinical guidelines, Exercise, Rehabilitation
Subjects: R Medicine > R Medicine (General)
R Medicine > R Medicine (General) > R735 Medical education. Medical schools. Research
R Medicine > RA Public aspects of medicine
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RC Internal medicine > RC925 Diseases of the musculoskeletal system
Divisions: Faculty of Medicine and Health Sciences > School of Primary, Community and Social Care
Related URLs:
Depositing User: Symplectic
Date Deposited: 18 Nov 2020 12:01
Last Modified: 18 Nov 2020 12:01
URI: https://eprints.keele.ac.uk/id/eprint/8888

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