What matters versus what’s the matter – exploring perceptions of person-centred practice in nursing and physiotherapy social media communities: a qualitative study
Thomas, Janet I.
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Ward, A., Eng, C., McCue, V., Stewart, R., Strain, K., McCormack, B., Dukhu, S., Thomas, J. & Bulley, C. (2018) What matters versus what’s the matter – exploring perceptions of person-centred practice in nursing and physiotherapy social media communities: a qualitative study. International Practice Development Journal, 8 (2), [Article: 3].
Background: Person-centred practice (PCP) is advocated internationally across multiple healthcare contexts and professions. Originating in nursing and medicine, its enactment in physiotherapy requires careful consideration.Aims and Objectives: to explore perceptions of PCP within nursing and physiotherapy online social media communities to gain insight into differences and similarities in how PCP may be enacted professionally.Methods: A large, online focus group was undertaken through an international tweet chat within the existing social media communities: WeNurses and Physiotalk. Participants were fully informed before participation. Tweets from the hour-long tweet chat plus 15 minutes were downloaded via Symplur. Analysis was undertaken using Interpretative Phenomenological Approach with consideration of group development of insight and meaning. Tweets were analysed if by nurses and physiotherapists, related to the research aim, and interpretable.Results: 233 of 504 tweets were analysed, by 38 nurses and 23 physiotherapists. Four themes are discussed here: 1. Relationship between professionals and patients, 2. Perceptions of who holds the power, 3. Treating the condition not the person, and 4. Impacts of organisational demands. Nurses and physiotherapists were seen to share many perceptions of person-centred practice, with the latter demonstrating a focus on informed decision making and education to empower. Discussion also showed a biomedical approach was often taken by physiotherapists. Patient privacy was highlighted by nurses. Explanatory theory was produced to incorporate the views of physiotherapists alongside established perceptions of PCP from nursing literature, expanding insights into profession-specific applications.Conclusions: Perceptions of PCP described by participants were generally supportive of previous PCP frameworks. Insights suggested some physiotherapists may perceive their professional role in a way that is not completely consistent with PCP; this would benefit from further exploration. The importance of education to empower patients within collaborative relationships was emphasised in relation to physiotherapy and may represent key aspects of the role.IMPLICATIONS FOR PRACTICE: • Discussion supported many similarities in the perceptions of PCP between nursing and physiotherapy online communities that resonate with existing frameworks, including prioritisation of what matters to the patient and empowerment through relationship, and the barriers to this resulting from structures and cultures within workplaces. • Participants from both professions emphasised the importance of focusing on the beliefs, values and priorities of the person, in development of a collaborative relationship, with shared decision making. • Physiotherapists involved in the tweetchat placed additional emphasis on the need to empower patients through education, to enable greater participation in informed and shared decision making. • Tweets suggested that there are risks to the enactment of PCP among physiotherapists. Some may focus on the condition rather than the person, and view the professional as expert with greater power in the therapeutic relationship.