En kvalitativ intervjustudie om fysioterapeuters bidrag og vurderinger i tverrfaglig oppfølging av pasienter med PPCS.

Abstract

Background: In the later years, interdisciplinary rehabilitation for patients with PPCS after mTBI have been developed in several locations in Norway. Physical therapy is a natural part of the rehabilitation; however, little is known about their contribution towards the interdisciplinary rehabilitation of patients with PPCS. Purpose: The purpose of this study is to provide increased insight regarding physical therapists’ experience with subject specific knowledge, and their contribution towards interdisciplinary rehabilitation for patients with PPCS after mTBI. Material and method: The study has a qualitative design with a phenomenological and hermeneutical theoretical foundation. A semi-structured interview was conducted with three different physical therapists, all experienced in the field of interdisciplinary rehabilitation for patients with PPCS. The interviews were analysed using thematic analysis. Two main topics emerged. Results: Two main categories with two respective subcategories emerged from the analysis: Perspectives of knowledge and patient follow-up. The results demonstrate that the PTs utilize both standardized tests and questionnaires combined with individualization by means of clinical reasoning to tailor the intervention towards the patient’s needs. Knowledge regarding the body, its movement and function are mentioned as the therapists’ contribution towards the interdisciplinary rehabilitation. This also influences their role in relation to their associates and patients. The therapists consider themselves as mentors. Relational knowledge and the ability to foster the patient’s autonomy played an important role towards creating a therapeutic alliance. Also ensuring that the patients felt safe, utilizing psychoeducation, bodily experiences, or a combination of both was highlighted by the therapists as a key to success. Conclusion: The study shows that interdisciplinary rehabilitation of patients with PPCS is complex and demands an individualized approach. The social meeting, and what happens “in-between” is important to individualize treatment. The results contribute with new insight regarding their contribution in the rehab team and what the therapists consider important in the treatment of patients with PPCS. Keywords: Physical therapy, interdisciplinary rehabilitation, mild traumatic brain injury, persistent postcommotio symptoms, therapeutic alliance.