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Original research
Physical therapists in integrated palliative care: a qualitative study
  1. Christopher M Wilson1,2,
  2. Christine H Stiller1,
  3. Deborah J Doherty1,
  4. Kristine A Thompson1,
  5. Alexander B Smith1 and
  6. Kelly L Turczynski1
  1. 1 Human Movement Science department – Physical Therapy Program, Oakland University, Rochester, Michigan, USA
  2. 2 Physical and Occupational Therapy, Beaumont Health, Troy, Michigan, USA
  1. Correspondence to Dr Christopher M Wilson, Human Movement Science department - Physical Therapy Program, Oakland University, Rochester, MI 48309-4401, USA; wilson23{at}oakland.edu

Abstract

Objectives The purpose of this study was to explore the perceptions and experiences of physical therapists (PTs) regarding their role in palliative care (PC) when practising in nations with advanced integration of PC into mainstream healthcare.

Methods This qualitative study included an electronic demographic survey and semistructured interview. Data analysis included descriptive statistics for demographics and the constant comparative method for interview results.

Results Thirteen PTs from eight nations identified four categories of roles and responsibilities: (1) working with patients and families, (2) being an interdisciplinary team (IDT) member, (3) professional responsibilities beyond direct patient care and (4) factors influencing the role of PTs in PC. Concepts identified were shifting priorities (increased family involvement, emphasis on psychosocial aspects and differences in care philosophy), care across the continuum (accommodating changes in patient status, increasing awareness of PTs’ role in varying disease states and working with the IDT) and changing perceptions about PT in PC (perceptions of PTs/others regarding PTs’ role in PC and professional responsibilities of the PT in PC).

Conclusions Based on participant responses, a previously published conceptual framework by Wilson et al in 2017 was updated and included an increased emphasis on patient wishes and dignity, treating breathlessness, patient advocacy within their family and use of technology and networking. Within PC, PTs play a key role on the IDT and can improve quality of life; however, multiple barriers exist to providing PT care within PC. Further advocacy is needed from PTs and professional organisations to integrate these services.

  • rehabilitation
  • quality of life
  • pain
  • communication

Data availability statement

Data are available on reasonable request. Contact the corresponding author for data.

https://doi.org/10.1136/bmjspcare-2019-002161

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    Data availability statement

    Data are available on reasonable request. Contact the corresponding author for data.

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    Footnotes

    • Twitter @cwilsondpt

    • Contributors All authors substantively contributed to methodology, institutional review board approval, participant recruitment, transcript proofreading, data analysis and interpretation, and manuscript composition and refinement. Participant interviews were completed by authors CMW, KAT and DJD. Interview transcription was completed by ABS, KLT and CMW. CMW accepts responsibility as guarantor for the integrity of the submitted work, obtained informed consent, had access to all data, controlled the decision to publish and attests that no undisclosed authors contributed to the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.