Search

Objective: Digital technology has become increasingly relevant in physiotherapy, but little is known about communication and interaction in video-based physiotherapy. Therefore, this study aimed to explore the experiences among patients and physiotherapists, of communication and interaction in digital, video-based physiotherapy. Methods: A qualitative interview study with a phenomenological approach was conducted. Participants were purposively recruited from primary health care clinics. Semi-structured, in-depth interviews were conducted with 10 physiotherapists and 6 patients. Interviews were recorded, transcribed, and analyzed using a phenomenological approach. Results: The analysis resulted in the overall theme Reaching for connection, which captured the central meaning of the participants' experiences. Four categories emerged from the analysis: 1) Closeness at a distance; 2) Overcoming limited bodily communication; 3) The technology as part of the meeting; and 4) Challenging the physical meeting as a norm. The results suggest that communication and interaction in digital settings differ from physical settings, but there is an ongoing adaptation process to this new paradigm. Conclusions: The results of this study show that video-based physiotherapy, while having several benefits according to both patients and physiotherapists, affects the communication in several ways. Physiotherapists need to acknowledge these limitations and seek strategies to adapt and to compensate for the reduced non-verbal elements and lack of touch. Attention to the physical room and shifting between positions (face/full figure) are suggested practical strategies, but also to practice awareness and embodied communication to improve receptivity in the interaction. [ABSTRACT FROM AUTHOR]

Purpose: Return to work often requires collaboration between different stakeholders. Rehabilitation coordination is a resource in coordinating efforts during sick leave to facilitate return to work. The purpose of the present study was to describe how people at risk for sick leave or on sick leave with mental health problems experienced rehabilitation coordination. Materials and Method: The study had a qualitative approach using qualitative content analysis as described by Graneheim and Lundman. Eleven semi-structured interviews were conducted with persons at risk for sick leave or on sick leave due to mental health problems and with experience of rehabilitation coordination. Results: The participants experience of rehabilitation coordination were described by the overarching theme Building a bridge with many bricks between the person and society. The theme was formed by four categories and eleven subcategories reflecting the complex context of rehabilitation coordination. The categories were Collaboration in a new setting, Unburdened within certain limits, The way back to work is a joint project and Recognising challenges beyond the person. Conclusions: People with mental health problems experienced rehabilitation coordination as a meaningful link between healthcare and work. However, rehabilitation coordination needs to be more recognised within healthcare to increase accessibility. It seems important that interventions are directed not only towards the person, but also include the workplace for a sustainable return to work. KEY POINTS: It is important to make rehabilitation coordination visible within primary health care and actively inform people on sick leave with mental health problems that it is an option, as they often have difficulties finding information. It will increase their accessibility and enable autonomous decisions. A respectful interplay based on a person-centred care approach seems fundamental for rehabilitation coordination. The interplay with rehabilitation coordinators and with other stakeholders affects the sick leave process and all parties need to collaborate for a sustainable return to work. Three-party meetings with the person on sick leave, the rehabilitation coordinator and the employer, as well as teamwork, may provide better conditions for return to work as this can ensure that all stakeholders are working towards prioritised goals. Targeted interventions at the workplace seem to be important and rehabilitation coordination could be a valuable bridge between healthcare and work for creating sustainable conditions for return to work. [ABSTRACT FROM AUTHOR]

Introduction: Worldwide, there are more than 264 million people with depression, which is the second-leading cause of years lived with disability. Physical activity can be useful in both preventing and treating mild to moderate depression, but few studies have explored patients' experience of physical activity. Purpose: To explore experiences of facilitators to initiate and maintain regular physical activity in people with depression. Methods: Adults of working age with mild to moderate depression participated in semi-structured interviews. Two researchers analyzed the data using qualitative content analysis. Results: Four categories were identified: 1) Getting over the threshold; 2) Hoping for improvement; 3) A wish to be independent but needing help; and 4) Feeling safe on one's own terms. Conclusion: The results indicate that knowledge and personal experience of how physical activity affects well-being, and an environment including social support, increase the possibilities for people with depression to initiate and maintain physical activity. To promote physical activity, it is important to be receptive to the person's experiences, desires, and needs and to involve them in the planning and adjustment of physical activity. Follow-up appointments, a stepwise approach, and encouragement are important to increase motivation. [ABSTRACT FROM AUTHOR]

Introduction: Vulvodynia is a common and complex pain syndrome with a negative impact on quality of life and sexual health. Physical therapy is still an underexplored treatment for vulvodynia. Women's experiences of their physical therapy treatment might shed light on meaningful aspects and essential keys to facilitate change. Purpose: To explore and describe women's experiences of physical therapy treatment for vulvodynia. Methods: A qualitative interview study, using qualitative content analysis. Fourteen women with a median age of 28 years and a median pain duration of 6.5 years participated. Digital interviews were conducted using a semi-structured interview guide with open-ended questions. Results: One theme, four categories and thirteen sub-categories were developed in the analysis. The theme, "Trying to become friends with your vulva," illuminate how the women approached and reconnected to their bodies in physical therapy. The treatment increased their awareness and provided explanations for their symptoms. Four categories described aspects of the theme: 1) untapped resources in a complex healthcare; 2) a matter of trust; 3) a guide to understanding your body; and 4) a new way forward but not the whole solution. Conclusion: Women with vulvodynia perceive physical therapy as a promising and yet unknown approach. Physical therapy treatment gives the opportunity to reconnect with the body and vulva in a new way, and to manage pain and muscle tension as part of a multidisciplinary treatment. [ABSTRACT FROM AUTHOR]

While physical activity is considered an important part of treatment for people with schizophrenia, little is known about their views on how to successfully commit to an exercise habit over time. This study explored experiences of motivators to start and maintain regular exercise among people with schizophrenia spectrum disorders. Five men and six women with schizophrenia spectrum disorders, 25–62 years old, who had been exercising for at least 6 months, were interviewed using a semi-structured guide. Interviews were analysed using qualitative content analysis. The positive experiences that the participants immediately felt in their bodies were the main motivator for exercise. These experiences were recalled and longed for in between bouts and consisted of physical sensations, mental well-being, and improved self-esteem. This experience-based driving force enabled the participants to pursue exercise despite sometimes feeling low, lacking resources, or struggling with side effects of medication. The positive change in body experience following exercise could be emphasised more when promoting exercise to people with schizophrenia. Exploring the instant body responses can keep up the drive and create hope for more long-term health effects. Physiotherapists have an important role in guiding patients to recognise and interpret body experiences. [ABSTRACT FROM AUTHOR]

Most people with common mental disorders are working despite symptoms. This study explores individuals' experiences of a work-directed rehabilitation, provided by occupational therapists and physiotherapists, aiming to promote work capacity in persons with common mental disorders. A qualitative content analysis was used, and 11 women and 8 men with depression or anxiety disorder were interviewed. They were 25–66 years old, had different occupations and were working full or part-time. The participants experienced a process interpreted as Increasing belief in one's capacity through supported reflection and practice. This theme reflects the shifting between "reflecting" and "doing" through rehabilitation and the growing hope for change. The increasing belief in one's capacity was developed through three stages, comprised of the categories To be supported by a professional, To realise things about oneself and To try new strategies for change. Strategies suggested by occupational therapists and physiotherapists have the potential to promote work capacity in people who are working while depressed and anxious. The results may deepen the understanding among rehabilitation professionals about the importance of a person-centred approach to people with common mental disorders, and to combine reflection and practical exercises to support the development of work-related strategies. Work-directed rehabilitation provided by occupational therapists and/or physiotherapists is beneficial to people with common mental disorders. Rehabilitation professionals should focus on facilitating self-efficacy among people with common mental disorders. An individualised person-centred approach seems important in order to initiate change. [ABSTRACT FROM AUTHOR]

Purpose: Infibulation is the most pervasive form of female genital cutting. Infibulated women face difficulties such as obstruction of urine and menstrual blood flow, sexual problems, and birth complications, and may therefore need medical defibulation. This study explores the lived experiences of young migrant women from Somalia and their views on undergoing medical defibulation in Sweden. Methods: A qualitative study was conducted using phenomenological lifeworld research. Data were collected through in-depth interviews with nine young women originating from Somalia, now resident in Sweden. The interviews were analysed to reveal the meaning of the phenomenon of infibulation. Results: The essential meaning of the phenomenon is characterized by a limbo regarding both infibulation and defibulation. There is a strong desire both to handle the Swedish perspective on infibulation and to stay with the Somalian cultural values. These women are being exposed to a tacit tradition that makes it hard to relate to the possibility of medical defibulation. As a result, the women perceive the possibility to undergo medical defibulation as limited or non-existent. Conclusions: Healthcare professionals can be a support to encourage women in need of medical defibulation to reflect on traditional ideals concerning infibulation and defibulation. [ABSTRACT FROM AUTHOR]

Background. Although the effectiveness of physical exercise for depression has been studied for many years, few studies have described patients' experiences of what exercise means to them, beyond the biological focus. Moreover, exercise as a treatment for depression is rarely explored in a physical therapy context. Objectives. The purpose of this study was to explore a physical therapy exercise intervention, as experienced by people with major depression. Design. This study had an inductive approach and used qualitative content analysis. Methods. Semistructured interviews were conducted with 13 people who participated in physical therapist-guided aerobic exercise in a randomized controlled trial. All participants were diagnosed with major depression according to the Diagnostic and Statistical Manual of Mental Disorders. Data were collected and analyzed in an inductive manner using qualitative content analysis according to Graneheim and Lundman. Results. Pour categories emerged: (1) struggling toward a healthy self, (2) challenging the resistance, (3) feeling alive but not euphoric, and (4) needing someone to be there for you. The participants experienced that although the exercise intervention was hard work, it enhanced the feeling of being alive and made them feel that they were doing something good for themselves. These feelings were a welcome contrast to the numbness and stagnation they experienced during depression. Limitations. The study was conducted in Swedish primary care. Transferability of results must be viewed in relation to context. Conclusions. Exercise in a physical therapy context can improve the patients' perception of their physical ability and create a sense of liveliness, improving their depressed state. The therapeutic relationship is essential for supporting the patient's vulnerability and ambiguity in an empathic and perceptive way. [ABSTRACT FROM AUTHOR]

Although depression is associated to physical discomfort, meanings of the body in depression are rarely addressed in clinical research. Drawing on the concept of the lived body, this study explores depression as an embodied phenomenon. Using a hermeneutic phenomenological approach, the analysis of narrative-based interviews with 11 depressed adults discloses a thematic structure of an embodied process of an ambiguous striving against fading. Five subthemes elicit different dimensions of this process, interpreted as disabling or enabling: feeling estranged, feeling confined, feeling burdensome, sensing life and seeking belongingness. In relation to clinical practice, we suggest that the interdisciplinary team can focus on enhancing the enabling dimensions, for example through guided physical activities to support the patient to feel more alive, capable and connected. Moreover, we suggest that the treatment process benefits from an increased awareness of the ambiguity in the patient's struggle, acknowledging both destructive and recharging elements of the withdrawing, and the perceived conflict in-between. [ABSTRACT FROM AUTHOR]

Objective: To examine the quality of evidence for exercise in the treatment of major depression, comparing specific study types; aerobic exercise vs. antidepressants, aerobic exercise vs. any physical activity, and aerobic exercise as augmentation therapy to treatment as usual vs. treatment as usual. Methods: Electronic searches for randomized controlled studies, reporting on treatment outcome in adults with major depression confirmed by a clinical interview. Quality of evidence was assessed using the Grading and Recommendations Assessment, Development and Evaluation and an additional risk of bias-protocol. Results: Fourteen eligible studies were retrieved, of which nine had low risk of bias. We found moderate quality of evidence that aerobic exercise has no significant effect compared to antidepressants. We found moderate quality of evidence that aerobic exercise at a moderate to high intensity has no significant effect compared to other forms of physical activity. We found low quality of evidence that exercise as augmentation to treatment as usual has a small effect - depression scores were on average 0.44 of a standard deviation lower - compared to treatment as usual. Conclusion: In general, exercise appears to be beneficial in the treatment of depression when used in combination with medication. A significant issue that is not well addressed in previous studies is the risks associated with exercise. Further, this review indicates that aerobic exercise is not more effective than other types of physical activity, pointing to a need to further investigate active components. [ABSTRACT FROM AUTHOR]

The generalized anxiety is characterized by long-term psychological and physiological discomfort. Pharmacological and psychotherapeutic interventions have been extensively examined, whereas knowledge is scant regarding other professional perspectives. This article focuses on the physiotherapeutic perspective on anxiety, exploring physiotherapists' perceptions of their treatment for patients with generalized anxiety. Semi-structured interviews were conducted with 10 physiotherapists working in psychiatry or primary health care. Data were analysed using qualitative content analysis, resulting in one main category and five subcategories. The main category 'To sense and make sense of one's anxiety' reflects the idea that physiotherapy works through immediate, tangible bodily experiences to help a person understand and handle his or her anxiety better. Five subcategories reflected different aspects of this main category: (1) the body is the arena of anxiety, (2) to get in touch with oneself, (3) to get down-to-earth with oneself, (4) to make sense of bodily sensations, and (5) to gain trust in one's capability to handle anxiety. In conclusion, the gradual bodily awareness of sensations, to sense and make sense of anxiety in physiotherapy treatment, becomes an opportunity to find ways to withstand and to manage symptoms of anxiety, encouraging an embodied self-trust. The emphasis on the immediately lived body involves the potential to learn how to endure anxiety instead of running away from it, to discern and to understand different sensations, leading to an integration of anxiety as being part of oneself rather than overflowing oneself. [ABSTRACT FROM AUTHOR]