BSc (Hons) Physiotherapy
Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/7262
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Item Exploring non-healthcare university students’ expectations, perceptions and beliefs of physiotherapy: A qualitative study(2018)Study design: Qualitative research with semi-structured interviews and open-ended questions. Objectives: This study aims to understand and explore the source of expectations, beliefs and perceptions of non-clinical background undergraduate students with no clinical experience and with no pre-existing conditions. Background: Expectations and satisfaction of physiotherapy on therapeutic outcome are widely researched. However little studies have been done to understand the reasons behind the expectations of physiotherapy coming from a population that has no prior experience or medical condition. In understanding their expectation, it allows practitioners to better manage their expectations, resulting in patient satisfaction. Methods: Five participants were recruited via purposeful and snowballing sampling for semi-structured one to one interview. A single participant was recruited for the pilot test to ensure uniformity and rigidity of data collected. One to one interview consist of two case studies accompanied by open-ended questions. The interviews were transcribed and analyzed using thematic analysis. Results: Five themes with multiple subthemes were generated. The main themes are personal experiences, professional support, view between public and private sector, self-efficacy and importance of mass communication. Discussion: In the absence of personal experience, participants gather experiences from social circle and their limited knowledge to form an expectation to physiotherapy rehabilitation. It was concluded that knowledge on the profession is important in balancing the negative or positive experiences of others. Therefore, health literacy is crucial in ensuring the population has better knowledge of the profession to form realistic and fair expectations. Hence ensuring patient satisfaction and compliance to physiotherapy program.Item Evaluation of walking speeds required at signal-controlled pedestrian crossings in Edinburgh: an observational study(2018)Objective: To evaluate the walking speeds required at signal-controlled pedestrian crossings in Edinburgh. Design: Non-experimental, quantitative and observational. Setting: 101 signal-controlled crossings (Pelican, Puffin or Toucan) in Edinburgh. Outcome Measures: Duration of solid green man phase and duration of the entire crossing period (solid green man phase and clearance phase) at each pedestrian crossing were measured with stopwatches. Distance of crossings were measured with a trundle wheel. Environmental factors like uneven surfaces, sloped roads, obstacles and auditory signals at pedestrian crossings were recorded. Results: Minimum speed required across the 101 crossings assuming pedestrians start crossing at initial appearance of green man had a mean of 0.57 ± 0.26ms−1(range of 0.07 – 1.33ms−1). Minimum required speed across the 101 crossing assuming pedestrians enter the crossing just at the end of the green man phase had a median of 1.22𝑚𝑠−1 (IQR = 0.98 – 1.65𝑚𝑠−1), with range of 0.36𝑚𝑠−1 to 5.02𝑚𝑠−1. 21% (21/101) of crossings had uneven surfaces, 1% (1/101) of crossings had presence of obstacles, 1% (1/101) of crossings had sloped pedestrian crossing and 63% (64/101) of crossings lacked auditory signals. Conclusion: Pedestrian crossings in Edinburgh does not allow sufficient time for elderly to cross the road in time. Insufficient time was given to clear the crossings in time assuming pedestrians start crossing right at the end of the green man phase for all pedestrians. Approximately one-quarter of the crossings had unsuitable road conditions for the elderly that reduces gait speed and increase risk of falls.Item A test-retest reliability and between-methods agreement study comparing the Infrared Optoelectronic volumetry and Infrared Depth volumetry against the Water Displacement volumetry, for the measurement of lower limb volumes in healthy individuals.(2018)Question: Does infrared optoelectronic volumetry and infrared depth volumetry demonstrate higher test-retest reliability and agreement when compared to the reference standard water displacement volumetry for the measurement of lower limb volumes? Design: Test-retest reliability and between-methods agreement study Participants: 13 healthy university students were recruited using convenience sampling without any participant dropouts Intervention: All participants’ dominant lower limb volume was measured using water displacement volumetry, infrared optoelectronic volumetry and infrared depth volumetry. Outcome measures: The test-retest reliability of each method was computed using ICC(2,1) model and SEm. A Bland and Altman difference plot was used to determine the limits of agreement between infrared optoelectronic volumetry and infrared depth volumetry to water displacement volumetry and its 95% confidence intervals. Results: Test-retest reliability and SEm of water displacement volumetry, infrared optoelectronic volumetry and infrared depth volumetry were ICC(2,1)=0.950 and SEm=367 ml; ICC(2,1)=0.933 and SEm=398 ml; and ICC(2,1)=0.891 and SEm=579 ml respectively. The Bland and Altman difference plot demonstrated that both the infrared optoelectronic volumetry and infrared depth volumetry overestimated limb volume by 1529 ml (95%CI = -211 to -2487 ml) and 1502 ml (95%CI=-466 to -2538 ml) respectively as compared to water displacement volumetry. Conclusion: There were excellent test-retest reliability for water displacement volumetry and infrared optoelectronic volumetry and good test-retest reliability for infrared depth volumetry. However, a lack of agreement between-methods was observed. Therefore, each methods cannot be used interchangeably.Item Validity of the Fitbit Charge 2 for measuring steps taken at moderate to fast walking speeds in healthy adults(2018)Purpose: To explore the validity of the Fitbit Charge 2 during treadmill walking in a healthy adult population. Design: A validation study with a within-subjects design. Participants: 26 healthy adults (18 females and 8 males, mean age 25.1±8.9 years) able to walk at a brisk walking speed for 2 minutes. Methods: The participants wore the Fitbit Charge 2 on their non-dominant wrist during treadmill walking at two different walking speeds (1.0 and 1.4 m/s) and hand positions (hands by side and hands in pockets) for 2 minutes each. Steps measured by the Fitbit Charge 2 were compared to video observation. Results: Inter-rater reliability of video observations was excellent (all ICC > 0.99). There were no significant differences in steps measured by the Fitbit and visual observation for hands in pockets 1.0 and 1.4 m/s (p>0.05) with mean differences (Fitbit – mean of raters) of 0.5 ± 3.1 and 1.5 ± 5.9 respectively. There were significant differences in steps measured by Fitbit and visual observation for hands by side 1.0 and 1.4 m/s (p<0.05) with mean differences of -5.9 ± 9.6, -9.3 ± 17.0 respectively. Conclusion: The Fitbit Charge 2 is considered valid for measuring steps taken during treadmill walking when walking with hands in pockets. Walking with hands by side at 1.0 and 1.4 m/s underestimated steps. Future research is needed to establish the validity of the Fitbit Charge 2 for this population.Item Water Displacement and Vertically Aligned Perometer’s Have Excellent Test-Retest Reliability but Poor Concurrent Validity: a reliability and between-methods agreement study.(2018)Objective: How much test-retest reliability and concurrent validity does a vertically aligned perometer have compared to the reference standard- water displacement? Design: Test-retest reliability and between-methods agreement study. Participants: Thirteen healthy university students were recruited using grab sampling, there were no participant dropouts. Intervention: Participants had their dominant lower limb volumes measured using both water-displacement and a vertically aligned perometer. Outcome measures: Test-retest reliability and the standard error measurement for both measurement methods were calculated using the ICC(2.1) model and within subject deviation respectively. A Bland-Altman plot was created to determine concurrent validity of the perometer compared to water-displacement with 95% confidence intervals. Results: Results for test-reliability for water-displacement was ICC(2,1)= 0.950 (95% CI:0.826 to 0.985) with a standard error of measurement of 492 ml. Results for the perometer limb volume measurement method was ICC(2,1)=0.933 (95% CI: 0.844 to 0.977) with a standard measurement error of 684 ml. The coefficients of variation for both methods were 0.24 and 0.18 respectively. The Bland-Altman plot showed that the perometer overestimates by a mean of 1528ml compared to water-displacement and the level of disagreement increases as limb volume increases. Conclusion: There was a lack of agreement between the two methods, which suggests that the results of the two methods are not interchangeable. The results of this study produced conflicting results, which suggests errors occurred while performing this study. It is recommended that studies are performed which compare the inter-rater reliability of water-displacement and the perometer which compare novice to professional clinicians.Item Exploring non-healthcare university students’ expectations, perceptions and beliefs of physiotherapy: A qualitative study(2018)Question: What are the expectations of non-clinical students regarding physiotherapy and what influences these expectations? Design: A qualitative study including 1-1 semi-structured interviews and using a phenomenological approach. Participants: Five business university students from one higher education institution. Results: Data from five 1-1 semi-structured interviews was collected and four overarching themes emerged: Do patients play an active role within physiotherapy treatment?, Physiotherapy is harmful in the early stages of healing, NHS vs private practice, a perceived gap in the quality of care and influences on patient expectations. There were varying opinions portrayed regarding the patient role within physiotherapy treatment, some participants viewed physiotherapy treatment as a passive process and other participants acknowledged accountability as a patient. It was also established that participants felt physiotherapy treatment for acute injuries was inappropriate. Resting and preventing painful movement was deemed better practice. A theme emerged regarding a difference in quality of care between private practice and NHS physiotherapy services. Participants expected that care within the NHS setting would be sub-standard and their expectations could only be met within private practice. Influences considered to have shaped expectations included: television, internet, personal experiences, family and peers. Conclusion: Many factors influence expectations of physiotherapy including television, Internet, personal experiences, familial and peers. Outlying factors may contribute towards expectations such as health related locus of control, health beliefs and the so-called “placebo effect”. This expectation may affect treatment outcome and adherence.Item Physiotherapists’ within the NHS believe eHealth integration can be enhanced: A qualitative Study(2018)Question: What are NHS physiotherapists’ views and perspective on eHealth integration: the barriers and facilitators? Design: Qualitative study using four semi-structured focus groups and phenomenology approach. Participants: Eighteen qualified physiotherapists currently working within the NHS. Results: Four themes emerged from the data collected from the focus groups; general attitudes, efficiency and effectiveness of providing quality of care, considerations of technology-use and eHealth knowledge and understanding. General attitudes towards eHealth were perceived to have both positive and negative impacts on eHealth integration. Fear and a lack of trust may be antagonists of eHealth integration whereas optimism and engagement were seen as enablers. Patient self-management, information sharing and organisational culture was seen to be complemented by eHealth. Inadequate technological resources and inconsistencies between IT systems were integrational barriers and access to support services was considered a facilitator. Lack of eHealth literacy and knowledge were regarded as potential barriers to eHealth uptake and limited awareness of the potential benefits of eHealth may restrict uptake. Increased frequency and efficiency of eHealth training was established as an enabler of future uptake within the NHS. Conclusion: Participants believe eHealth can have a negative impact on health inequality if not integrated efficiently. Lack of trust and negative attitudes may be barriers to uptake. Increased awareness of eHealth benefits, optimised training and technological support are facilitators of efficient integration. Participants believe eHealth has positive implications on organisational culture, patient self-management and quality of care. Further research is required to understand how to enhance future NHS’ eHealth integration.Item Exploring Perceptions of Person Centred Practice in Nursing and Physiotherapy Online Communities: A Qualitative Study(2018)Background and Purpose: Person-centred care ideals are being adopted into NHS practices/clinical guidelines across multiple healthcare professions. Originating in nursing/medical fields, there is need for standardised definitions of person-centred practice to be applied to professions individually. Physiotherapy, as noted in literature, has little theory in relation to the matter compared with other healthcare professions. The purpose of this study was to explore Physiotherapists perspectives of person centred practice in comparison to those of nurses. Methods: This study was a secondary thematic analysis of existing data by way of a phenomenological approach. The primary research was an international twitter chat exploring perceptions of person centred care among nursing and physiotherapy online communities, with recruitment of participants taking place online among existing social media communities WeNurses and Physiotalk. Results: 233 unique tweets from 61 nurses and physiotherapists were identified relating to the specific research aim. Five themes emerged from the data: 1) ‘What matters to the person’; 2) ‘Practitioner-led practice’; 3) ‘Who holds the power – Patient vs Practitioner’; 4) ‘Collaboration’ and 5) ‘Barriers and Facilitators to Person centred practice’. Physiotherapists engaged the most generating the greatest number of tweets. Conclusions: The present study identifies a need for change within physiotherapy to incorporate a person-centred approach more easily into practice, with a greater focus on looking at a person biopsychosocially, and not biomechanically. An emphasis on ‘education to empower the patient’, shifting the power of healthcare decision making from the clinician to the patient is paramount to person centred practice within physiotherapy.Item Exploring non-healthcare students expectations, perceptions and beliefs of Physiotherapy: A qualitative study.(2018)Question: What are non-healthcare university student’s expectations, perceptions, and beliefs of Physiotherapy and the factors that influence these thoughts? Design: A qualitative study with the use of semi-structured interviews taking a phenomenological approach. Participants: Five undergraduate university students from the School of Business at a UK higher education institution. Results: Four overarching themes emerged from the interviews; (1) A narrow view of Physiotherapy exists, (2) Locus of Control – is the patient’s health in the hands of the therapist or their own? (3) NHS Physiotherapy services versus private practice, and (4) Past experiences and various sources of media influence perceptions of Physiotherapy. Participants appeared most knowledgeable about musculoskeletal aspects of Physiotherapy in comparison to other clinical areas Physiotherapists may be involved. Locus of control and a patient’s stance on this appeared to be an important aspect of the participant’s beliefs surrounding a general recovery process. Negative connotations were associated with the NHS Physiotherapy services, with an expectation one would receive lower quality of care from the NHS in comparison to private practice Physiotherapy. Various past experiences and sources of media emerged as the most prevalent influencing factors of these expectations, perceptions, and beliefs. Conclusion: Expectations, perceptions and beliefs of Physiotherapy are individual although findings from this study suggest that trends exist. Eliciting these opinions prior or from the outset of a healthcare encounter could be beneficial for enhancing the quality of care and achieving optimal outcomes.Item The required gait speed for analysed pedestrian crossings in Edinburgh. An observational study into the safety of a number of crossings in the region of Edinburgh.(2018)Objective: To investigate the required gait speed to safely cross a number of pedestrian crossings in Edinburgh. Relevance: With an increasing ageing population and a rising number of pedestrian casualties, the safety of pedestrian crossings should be considered. The purpose of this study is to identify the gait speed required to safely cross at pedestrian crossings in Edinburgh. Results can then be compared with the Department for Transport (DFT) recommended legislated value of 1.2m/s walking speed and older people’s gait speed from previous studies. A prediction can be made as to whether the measured crossings are safe, and justify a recommendation to re-evaluate current legislation. Design: Descriptive observational design. Environment: 101 PELICAN, Puffin and Toucan crossings in Edinburgh were selected using pragmatic cluster sampling. Measures: Time of ‘green man’ phase and ‘green man on’ to ‘end of red vehicle light’ phase. Distance of road crossing. Environmental factors were documented. Results: The mean gait speed during the ‘green man’ phase was 1.16m/s. During ‘green man on’ to ‘end of vehicle light’ was 0.57m/s. 49.5% of crossings required a gait speed of greater than 1.2m/s to safely cross. Conclusion: The average required gait speed at the measured crossings was below 1.2m/s. However, 49.5% of crossings were faster than the DFT recommended legislated value. Therefore, highlighting the need for re-evaluation of the DFT guidelines to increase the safety of crossings for pedestrians.