"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

10.1080/09638288.2023.2240706

0963-8288

Barth, Cornelia Anne

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Donovan-hall, Maggie

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Blake, Catherine

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Akhtar, Noor Jahan

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Al-barawi, Saeda

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Kazibwe, Herman

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O’sullivan, Cliona

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Barth, Cornelia Anne

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Donovan-hall, Maggie

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Blake, Catherine

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Akhtar, Noor Jahan

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Al-barawi, Saeda

13219c48-7809-4251-844c-94066104a128

Kazibwe, Herman

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O’sullivan, Cliona

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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

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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