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"Otherwise horizontal ellipsis he will be a beggar": a focus group study to understand the perspectives of physiotherapists about measuring rehabilitation outcomes and impact in low-resource and conflict-affected settings

"Otherwise horizontal ellipsis he will be a beggar": a focus group study to understand the perspectives of physiotherapists about measuring rehabilitation outcomes and impact in low-resource and conflict-affected settings
"Otherwise horizontal ellipsis he will be a beggar": a focus group study to understand the perspectives of physiotherapists about measuring rehabilitation outcomes and impact in low-resource and conflict-affected settings

Purpose: rehabilitation outcomes are important for patients, professionals and policy makers. Most outcome measures (OMs) were developed for “Western” contexts and may be inadequate for low-resource and conflict settings, where the ability to demonstrate impact would be critical to strengthening the sector. This study aims to understand perspectives of physiotherapists from challenging environments regarding current practices, value, barriers, and facilitators of measuring rehabilitation outcomes. 

Materials & methods: focus group discussions were held in English with 35 physiotherapists from 18 countries. Audio recordings were transcribed verbatim, anonymised, and analysed using reflexive thematic analysis. Results: Four themes emerged illustrating the levels at which outcomes and measures were discussed: User (patients, families), provider (physiotherapists, rehabilitation workers), application (OMs), and structure (management, health system). Participants discussed diversity in current practices and patient populations, utility of OMs and a neglected rehabilitation sector lacking investment. Barriers to progressing outcome measurement included lacking patient health literacy, rehabilitation provider training, valid OMs, and leadership. Participants suggested improved patient involvement, routine outcome measurement by using, developing, or adapting simple, context- and stakeholder-relevant OMs, and support from management. 

Conclusions: these insights illustrate the need of and provide robust recommendations for context-adapted development of rehabilitation outcome measurement in various challenging contexts.

Rehabilitation outcomes, conflict-affected, focus group, low-resource, outcome measures, physiotherapy, reflexive thematic analysis
0963-8288
Barth, Cornelia Anne
cbec548d-e7d9-45ee-80bd-7b966585f7cf
Donovan-hall, Maggie
5f138055-2162-4982-846c-5c92411055e0
Blake, Catherine
a6080d0b-27ba-4360-be56-a4e39543154e
Akhtar, Noor Jahan
ae03a3b4-1617-4d30-a496-6d3883c7bdca
Al-barawi, Saeda
13219c48-7809-4251-844c-94066104a128
Kazibwe, Herman
c0f7b8ac-841f-44d0-bc47-c134cf56dbcb
O’sullivan, Cliona
3b0fc531-24c5-4198-855a-13bfa912238c
Barth, Cornelia Anne
cbec548d-e7d9-45ee-80bd-7b966585f7cf
Donovan-hall, Maggie
5f138055-2162-4982-846c-5c92411055e0
Blake, Catherine
a6080d0b-27ba-4360-be56-a4e39543154e
Akhtar, Noor Jahan
ae03a3b4-1617-4d30-a496-6d3883c7bdca
Al-barawi, Saeda
13219c48-7809-4251-844c-94066104a128
Kazibwe, Herman
c0f7b8ac-841f-44d0-bc47-c134cf56dbcb
O’sullivan, Cliona
3b0fc531-24c5-4198-855a-13bfa912238c

Barth, Cornelia Anne, Donovan-hall, Maggie, Blake, Catherine, Akhtar, Noor Jahan, Al-barawi, Saeda, Kazibwe, Herman and O’sullivan, Cliona (2023) "Otherwise horizontal ellipsis he will be a beggar": a focus group study to understand the perspectives of physiotherapists about measuring rehabilitation outcomes and impact in low-resource and conflict-affected settings. Disability and Rehabilitation. (doi:10.1080/09638288.2023.2240706).

Record type: Article

Abstract

Purpose: rehabilitation outcomes are important for patients, professionals and policy makers. Most outcome measures (OMs) were developed for “Western” contexts and may be inadequate for low-resource and conflict settings, where the ability to demonstrate impact would be critical to strengthening the sector. This study aims to understand perspectives of physiotherapists from challenging environments regarding current practices, value, barriers, and facilitators of measuring rehabilitation outcomes. 

Materials & methods: focus group discussions were held in English with 35 physiotherapists from 18 countries. Audio recordings were transcribed verbatim, anonymised, and analysed using reflexive thematic analysis. Results: Four themes emerged illustrating the levels at which outcomes and measures were discussed: User (patients, families), provider (physiotherapists, rehabilitation workers), application (OMs), and structure (management, health system). Participants discussed diversity in current practices and patient populations, utility of OMs and a neglected rehabilitation sector lacking investment. Barriers to progressing outcome measurement included lacking patient health literacy, rehabilitation provider training, valid OMs, and leadership. Participants suggested improved patient involvement, routine outcome measurement by using, developing, or adapting simple, context- and stakeholder-relevant OMs, and support from management. 

Conclusions: these insights illustrate the need of and provide robust recommendations for context-adapted development of rehabilitation outcome measurement in various challenging contexts.

Text
370_Otherwise … he will be a beggar a focus group study to understand the Perspectives of physiotherapists about measuring rehabilitation outcomes and impact in low-resource and conflict-affected settings - Accepted Manuscript
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More information

Accepted/In Press date: 21 July 2023
e-pub ahead of print date: 1 August 2023
Additional Information: Publisher Copyright: © 2023 Informa UK Limited, trading as Taylor & Francis Group.
Keywords: Rehabilitation outcomes, conflict-affected, focus group, low-resource, outcome measures, physiotherapy, reflexive thematic analysis

Identifiers

Local EPrints ID: 482827
URI: http://eprints.soton.ac.uk/id/eprint/482827
ISSN: 0963-8288
PURE UUID: cec22945-d10c-42a0-980e-57013dd622ae

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Date deposited: 13 Oct 2023 16:31
Last modified: 01 Aug 2024 04:01

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Contributors

Author: Cornelia Anne Barth
Author: Catherine Blake
Author: Noor Jahan Akhtar
Author: Saeda Al-barawi
Author: Herman Kazibwe
Author: Cliona O’sullivan

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