An exploration of person-centred practices among emergency department physiotherapists

Naylor, John

Abstract

Person-centred practice (PCP) constitutes an important, individualising approach that strives to confront a legacy of healthcare paternalism. The biomedical roots of physiotherapy, alongside context-specificity of PCP, hinder realisation of this humanistic model, particularly where research is lacking. This thesis explores how PCP is understood and experienced by patients and primary contact physiotherapists within emergency departments (ED) to address this identified research gap.
A qualitative systematic review of musculoskeletal physiotherapist and patient views on PCP informed subsequent mixed-methods exploration of ED physiotherapists’, and qualitative exploration of ED patients’, views of PCP. The systematic reviews’ findings underscored the importance of person-centred traits, communication and empowerment when treating the unique person, generating novel contributions on how clinically brave ED physiotherapists might achieve empowerment through meaningful activity. The subsequent mixed-methods exploration of person-centredness among ED physiotherapists revealed a cognisance of their struggle between biomedicine and person-centredness, where entering a patient’s world helped navigate the challenging line between ED attenders’ wants and needs. Finally, a qualitative study exploring perceptions on the person-centredness of ED patients who had their care episode managed by a primary-contact physiotherapists, recognised the benefits of this ED physiotherapy model, through aspects of their connection, competence and time, while illustrating patients’ experience of ED physical environment. Novel contributions from the patient perspective, here, reflected a cognisance of certain environment limitations to PCP, as well as institutional challenges to their personhood, with a suggestion that ED patients anticipated a validation of their visit and valued the educational aspects that the physiotherapists provided.
The combined findings produced common threads on the importance of therapists holding an empowering attitude toward, and listening, to patients as well as pursuing meaningful interaction with them. This shaped specific recommendations, with practical application, that are offered to assist ED physiotherapists PCP within the UK and beyond.

Citation

Naylor, J. An exploration of person-centred practices among emergency department physiotherapists. (Thesis). University of Hull. https://hull-repository.worktribe.com/output/4871223

• Thesis Type: Thesis
• Deposit Date: Oct 25, 2024
• Publicly Available Date: Oct 29, 2024
• Keywords: Health studies
• Public URL: https://hull-repository.worktribe.com/output/4871223
• Additional Information: Health Studies; University of Hull
• Award Date: Aug 28, 2024