Browsing by Author "Van Nes, Michelle Beatriz"

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    Perception of physiotherapy care in a surgical ICU : the patients’ perspectives
    (Stellenbosch : Stellenbosch University, 2016-03) Van Nes, Michelle Beatriz; Karachi, Farhana; Hanekom, Susan D.; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Physiotherapy.
    ENGLISH ABSTRACT: INTRODUCTION: Physiotherapy practice in the intensive care unit (ICU) is changing. Early mobilisation programmes are included and prioritised. Methods and measures to assess physiotherapy effectiveness in the ICU have often been geared to physiological data. It is unclear if the patients’ perspectives and satisfaction regarding care in the ICU have been investigated, specifically with regard to physiotherapy. METHODS: A scoping review was undertaken with the aim of determining how patient perception and satisfaction regarding critical care is measured. Seven databases were searched using various combinations of selected keywords for the process of identification. The review results informed the planning of the primary study. A primary qualitative study was conducted to describe patients’ perceptions and satisfaction with regard to physiotherapy care received during their surgical ICU stay. Patients were included via purposive sampling into the primary study. Audiotaped, semi-structured interviews of 25-60 minutes each were completed with the included patients. Data was transcribed and then analysed via inductive and interpretive content analysis. Trustworthiness of results was ensured through reflexivity, checking of transcriptions, peer review and member checking. RESULTS: A total of 1 631 hits were reduced to 28 studies, which were included into the scoping review. Only two studies were conducted in Africa compared with ten in Europe and seven in Northern America. Ten of the included studies investigated a particular service such as nursing care, emergency care and physiotherapy with regard to patient perception and satisfaction. Only one article, published in 2008, investigated patient satisfaction in physiotherapy. Various outcome measures that measure perception and/or satisfaction were identified; however, there is currently no validated and reliable instrument to assess patient satisfaction with care in the ICU. Eighteen patients, of which ten patients were male, were purposefully selected for the primary study. The median patient age was 44 years and the median ICU length of stay was six days. Twelve themes arose from the data analysis, including: 1) patient expectations and understanding; 2) physiotherapy activities and the implication of mobilisation; 3) physiotherapy benefits and progression; 4) physiotherapy value; 5) interdisciplinary team; 6) the physiotherapist; 7) safety; 8) tangebilities; 9) continuity of care; 10) satisfaction; 11) communication; and 12) patient perception and experience. These themes as well as key messages, future research and contributions to literature were discussed. Barriers and facilitators for the relevant themes were also discussed. CONCLUSION: While there is no gold standard for measuring patient perception and satisfaction regarding ICU care, it can and should be measured. With current and on-going changes to both physiotherapy and ICU care practices, patients can share their experiences of the ICU with greater ease. This thesis demonstrated that patients’ perception of ICU physiotherapy is influenced by many factors. While patients perceived ICU physiotherapy both positively and negatively, the majority of patients were satisfied with the care they received. Patient perception and satisfaction in the ICU can be evaluated and used to ensure quality of care and ultimately provide a component to the development of evidence-based physiotherapy practice in the ICU.