Current Practice of Physical Activity Counselling within Physiotherapy Usual Care and Influences on Its Use: A Cross-Sectional Survey
Abstract
:1. Introduction
- What elements of physical activity counselling are currently incorporated in routine healthcare interactions by physiotherapists working in a local health district in Australia?
- What are physiotherapists’ perceptions of their patients’ readiness for structured community-based physical activity on discharge from physiotherapy care?
- Which influences do physiotherapists report to affect incorporation of physical activity counselling into routine healthcare interactions?
- Is there a relationship between the incorporation of physical activity counselling within routine care, physiotherapist characteristics and influences reported by physiotherapists?
2. Materials and Methods
2.1. Study Design
2.2. Context
2.3. Participants
2.4. Data Collection Measures and Tools
In a Typical Week, How Frequently Do You Undertake Each of the Below for Your Patients Who Could Be More Active: | ||
Raise or discuss overall PA | Use motivational language | Recommend community-based exercise programs |
Assess PA subjectively | Provide self-monitoring strategy | Recommend community-based recreation programs |
Assess PA objectively | Provide handouts | Recommend community-based sports |
Set PA goals | Review PA status & provide advice | Make contact with community provider |
Make PA action plans | Investigate PA options | Attend ≥1 community-based session with patient |
2.5. Procedure
2.6. Sample Size
2.7. Data Analysis
3. Results
3.1. Participants’ Characteristics
3.2. Current Practice of Physical Activity Counselling by Physiotherapists within Routine Care
3.3. Physiotherapist Perceptions of Their Patients’ Readiness for Structured Community Based Physical Activity
3.4. Influences on Physiotherapists’ Ability to Incorporate PA Counselling into Practice within the COM-B Framework, and Its Relationship with Total Number of PA Counselling Elements
3.5. Relationship between PA Counselling Skills and Incorporating Elements
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Disclosure Statement
Conflicts of Interest
References
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Characteristic | n = 84 | |
---|---|---|
Age (yr), n (%) | ||
<25 | 19 (23) | |
25–34 | 40 (48) | |
35–44 | 18 (22) | |
45 and over | 6 (7) | |
Gender, number female, n (%) | 66 (79) | |
Years practised as a physiotherapist (years) | ||
0–2 | 17 (20) | |
2–5 | 23 (28) | |
5–8 | 13 (16) | |
8–12 | 10 (12) | |
>12 | 20 (24) | |
Hospital, n (%) | ||
Hospital 1 | 44 (52) | |
Hospital 2 | 18 (21) | |
Hospital 3 | 14 (17) | |
Hospital 4 | 7 (8) | |
Hospital 5 | 1 (1) | |
Employment status, n (%) | ||
Permanent staff | 55 (67) | |
Contract staff | 17 (21) | |
First year graduate program | 10 (12) | |
Full time equivalent, n (%) | ||
Full-time | 65 (78) | |
Part-time | 18 (22) | |
Classification of position, n (%) | ||
Level 1–2: Junior clinician | 47 (57) | |
Level 3–4: Senior clinician | 26 (32) | |
Level 5–6: Health Professional Educator/Clinical Specialist | 5 (6) | |
Manager | 4 (5) | |
Position, n (%) | ||
Rotational position | 43 (53) | |
Non-rotating position | 38 (47) | |
Practice setting, n (%) | ||
Inpatient | 43 (51) | |
Outpatient/Community | 29 (35) | |
Mixed inpatient and outpatient | 12 (14) | |
Area of physiotherapy, n (%) * | ||
Musculoskeletal/Rheumatology/Hands | 23 (27) | |
Rehabilitation | 21 (25) | |
Orthopaedics | 17 (20) | |
Aged Care | 17 (20) | |
Cardiopulmonary | 14 (17) | |
Intensive Care | 11 (13) | |
Emergency Department | 10 (12) | |
Surgical | 10 (12) | |
Medical | 10 (12) | |
Cancer | 6 (7) | |
Women & Men’s health | 6 (7) | |
Acute Neurological | 6 (7) | |
Other (e.g., paediatrics, renal, chronic disease, palliative care) | 8 (10) | |
Current workload | ||
Mean (SD) number of patients seen in a typical workday | Inpatient | 10.2 (2.6) |
Outpatient | 8.0 (4.5) | |
Mixed | 6.5 (2.3) | |
Mean (SD) time spent with patient per session (min) | Inpatient | 32.8 (11.6) |
Outpatient | 46.7 (20.3) | |
Mixed | 46.8 (11.7) | |
Mean (SD) number of occasions of service before discharged | Inpatient | 8.8 (12.8) |
Outpatient | 6.4 (3.9) | |
Mixed | 8.4 (14.1) | |
Mean (SD) number of new patients seen per week | Inpatient | 10.8 (7.2) |
Outpatient | 9.2 (11.3) | |
Mixed | 9.6 (8.7) | |
Training | ||
Attended training on behaviour change/ motivational interviewing/ health coaching, yes, n (%) | 30 (36) |
Demographic Categories | Mean (SD) Number of PA Counselling Elements Used |
---|---|
PT years of experience | |
<2 years (n = 17) | 4.0 (3.0) |
2 ≤ 5yrs (n = 23) | 5.0 (3.6) |
5 ≤ 8yrs (n = 13) | 5.7 (3.5) |
8 ≤ 12yrs (n = 10) | 3.8 (3.4) |
>12 years (n = 20) | 5.1 (3.6) |
Setting | |
Inpatient (n = 43) | 3.6 (3.0) |
Outpatient/community (n = 29) | 6.6 (3.5) |
Mixed inpatient/outpatient (n = 12) | 5.3 (2.7) |
Area of physio practice * | |
MSK; Rheum; Hands (n = 19) | 5.1 (2.9) |
Orthopaedics (n = 17) | 4.8 (3.2) |
Rehabilitation (n = 21) | 5.7 (3.8) |
Aged care (n = 17) | 5.5 (4.1) |
Cardiopulmonary (n = 14) | 4.9 (3.2) |
ED (n = 10) | 6.7 (3.5) |
Cancer (n = 6) | 4.2 (3.4) |
Medical (n = 10) | 2.7 (1.7) |
Women and Men’s Health (n = 6) | 5.3 (3.6) |
Surgical (n = 10) | 3.7 (2.9) |
ICU (n = 11) | 4.5 (3.2) |
Neuro (n = 6) | 4 (3.3) |
Other: Paediatrics, Renal, Palliative (n = 8) | 3.5 (2.4) |
Yes n (%) | No n (%) | Unsure n (%) | |
---|---|---|---|
Ready to be referred directly to community PA programs | 26 (32) | 44 (54) | 12 (15) |
Would benefit from a transitional stage with a health professional-led program | 76 (90) | 2 (2) | 6 (7) |
Require further treatment from a health professional prior to referral | 59 (71) | 12 (14) | 12 (14) |
Benefit from supported introduction or extra advice about community PA programs from a health professional | 79 (94) | 2 (2) | 3 (4) |
Mean (SD) | Percentage of Total Barriers Reported in Each Category | |
---|---|---|
Total barriers reported (0–53) | 25.1 (8.7) | 47 |
Capability (0–28) | 13.3 (5.7) | 47 |
Knowledge (0–14) | 7.6 (2.6) | 54 |
Cognition (0–13) | 5.0 (3.8) | 39 |
Opportunity (0–12) | 7.1 (2.9) | 59 |
Physical (0–7) | 4.7 (1.8) | 67 |
Social (0–5) | 2.4 (1.7) | 47 |
Motivation (0–13) | 4.8 (2.9) | 37 |
Number (95% CI) PA counselling elements * | p value | |
Total barriers | −0.3 (−0.3 to −0.2) | <0.01 |
Barriers in Capability | −0.3 (−0.4 to −0.2) | <0.01 |
Barriers in Opportunity | −0.2 (−0.4 to 0.1) | 0.21 |
Barriers in Motivation | −0.2 (−0.4 to 0.1) | 0.13 |
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Zhu, S.; Sherrington, C.; Jennings, M.; Brady, B.; Pinheiro, M.; Dennis, S.; Christie, L.J.; Sidhu, B.; Haynes, A.; Greaves, C.; et al. Current Practice of Physical Activity Counselling within Physiotherapy Usual Care and Influences on Its Use: A Cross-Sectional Survey. Int. J. Environ. Res. Public Health 2021, 18, 4762. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18094762
Zhu S, Sherrington C, Jennings M, Brady B, Pinheiro M, Dennis S, Christie LJ, Sidhu B, Haynes A, Greaves C, et al. Current Practice of Physical Activity Counselling within Physiotherapy Usual Care and Influences on Its Use: A Cross-Sectional Survey. International Journal of Environmental Research and Public Health. 2021; 18(9):4762. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18094762
Chicago/Turabian StyleZhu, Shiyi, Catherine Sherrington, Matthew Jennings, Bernadette Brady, Marina Pinheiro, Sarah Dennis, Lauren J. Christie, Balwinder Sidhu, Abby Haynes, Colin Greaves, and et al. 2021. "Current Practice of Physical Activity Counselling within Physiotherapy Usual Care and Influences on Its Use: A Cross-Sectional Survey" International Journal of Environmental Research and Public Health 18, no. 9: 4762. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18094762