Exploring the perceptions of physiotherapy students on their preparedness to include exercise in the treatment of cancer patients

Date
2022-04
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Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH SUMMARY: Undergraduate health professions curricula should equip students with the requisite knowledge, skills and attitudes to manage patients within their local communities. Given the ever increasing incidence of cancer in South Africa, it could be argued that responsive curricula should include cancer-related content. Current literature, however, indicates that qualified physiotherapists have had limited undergraduate education on exercise for cancer patients. This study aimed to explore the perceptions of undergraduate physiotherapy students at Stellenbosch University regarding their preparedness to include exercise in the management of cancer patients. A qualitative research design was used. The study was conducted in the interpretivist paradigm with a phenomenological research approach. Purposive sampling was employed to recruit fourth year physiotherapy students with exposure to the management of cancer patients. Focus groups were used for data collection. An experienced, independent facilitator guided the two focus group discussions, using a semi-structured interview guide. Thirteen students provided written informed consent to participate in the study. Ethical approval was obtained to conduct this study. Thematic analysis was used to analyse the data. Four themes were identified namely: i) students’ perspectives of cancer; ii) students’ knowledge of cancer in the context of physiotherapy; iii) students’ response to providing treatment; and iv) students’ perspectives on the implications for the curriculum. Cancer was regarded as a comorbidity, and students preferred to focus their management on the familiar signs and symptoms patients presented with. Physiotherapy students reported limited knowledge of cancer and expressed uncertainty about their role in the management of cancer patients. Students were perplexed by the use of exercise for cancer patients and were concerned about worsening the patient’s condition. Students reported an array of distressing emotions during the management of cancer patients, with no reports of debriefing mechanisms. Suggestions for improvement of the curriculum included focused time on cancer-related content, specific skills training and equitable allocation of cancer patients during clinical rotations. The study findings highlight the interplay between the study participants’ learning needs and their identity development as physiotherapists during the management of cancer patients. Study participants suggested that the curriculum could better prepare them for the management of cancer patients by creating opportunities for them to learn through collaboration, exposure to cancer patients and community of practice. Curriculum developers should reconsider foci and time allocation to better prepare undergraduate physiotherapy students to manage cancer patients.
AFRIKAANSE OPSOMMING: Voorgraadse gesondheidsberoep-kurrikulums behoort studente met die nodige kennis, vaardighede en gesindheid toe te rus om pasiente in hul plaaslike gemeenskappe te kan behandel. Met die toenemende voorkoms van kanker in Suid-Afrika argumenteer ons dat reaktiewe kurrikulums kanker-verwante inhoud moet bevat. Huidige literatuur dui in teenstelling daarop dat gekwalifiseerde fisioterapeute beperkte voorgraadse onderrig ontvang oor spesifieke oefeninge vir kankerpasiente. Die doel van hierdie studie was om die persepsies te verken van voorgraadse fisioterapie studente by Stellenbosch Universiteit oor hul gereedheid om oefeninge in te sluit tydens die behandeling van kankerpasiente. Hierdie studie het ‘n kwalitatiewe navorsingsontwerp gebruik en is gegrond in ‘n interpretivistiese benadering en gelei deur ‘n fenomenologiese raamwerk. ‘n Doelgerigte steekproefneming is geneem om vierde-jaar fisioterapie studente te werf met blootstelling aan die hantering van kankerpasiente. Fokusgroepe is gebruik om data te versamel en ‘n ervare, onafhanklike fasiliteerder het die twee besprekings gelei deur ‘n semi-gestruktureerde onderhoudgids te gebruik. Dertien studente het geskrewe ingeligte toestemming gegee om deel te neem aan die studie. Etiese toestemming is verkry om die studie uit te voer en tematiese analise is gebruik om die data te analiseer. Vier temas is geidentifiseer: i) studente se perspektiewe oor kanker; ii) studente se kennis oor kanker in die konteks van fisioterapie; iii) studente se reaksie oor behandeling van kankerpasiente; en iv) studente se perspektiewe oor die implikasies van die kurrikulum. Kanker is as ‘n komorbiditeit beskou en studente het verkies om te fokus op die behandeling van bekende tekens en simptome van pasiente. Fisioterapie studente het beperkte kennis van kanker gerapporteer en onsekerheid uitgespreek oor hul rol in die hantering van kankerpasiente. Studente is verwar deur die konsep van spesifieke oefeninge vir kankerpasiente en was bekommerd dat hulle die pasiente se toestand sou vererger. Studente het ‘n aantal ontstellende emosies gerapporteer tydens die hantering van kankerpasiente met geen meganismes vir ontlonting nie. Voorstelle vir die verbetering van die kurrikulum sluit die volgende in: gefokusde tyd aan kanker-verwante inhoud, spesifieke vaardigheidsopleiding en regverdige toekenning aan kankerpasiente tydens kliniese rotasies. Die studie se bevindinge beklemtoon die interaksie tussen die studente se leerbehoeftes en hul identiteitsontwikkeling as fisioterapeute tydens die behandeling van kankerpasiente. Die studente het voorgestel dat die kurrikulum hulle beter kon voorberei vir die hantering van kankerpasiente deur geleenthede te skep vir hulle om te leer deur samewerking inisiatiewe en genoegsame blootstelling te gee aan kankerpasiente en die praktykgemeenskap. Kurrikulum ontwikkelaars behoort dus hul fokus te heroorweeg en tydstoekenning aan te pas om voorgraadse fisioterapie studente beter voor te berei om kankerpasiente te kan behandel.
Description
Thesis (MPhil)--Stellenbosch University, 2022.
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