Electronic Thesis and Dissertation Repository

Degree

Doctor of Philosophy

Program

Health and Rehabilitation Sciences

Supervisor

Dr. S. Deborah Lucy

Abstract

A mixed methods program of research was undertaken in order to better understand the roles of physiotherapists within Ontario primary health care (PHC) teams. A profile of Ontario PHC teams (Family Health Teams and Community Health Centres) was generated to determine the complement of providers and provision of health programming within each PHC team. This first study provided an important contextual backdrop as well as a means to purposefully sample participants for the two following studies. The second study used qualitative descriptive method to explore the perceptions of family physicians and nurse practitioners related to the inclusion of physiotherapists (PTs) within Ontario PHC teams. The final study used grounded theory method to generate an explanatory scheme to explicate how PTs currently working within Ontario PHC team enact practice. Overall, Family Health Teams (FHTs) and Community Health Centres (CHCs) were characterized by diverse teams and both models offered health programming. Physiotherapists were integrated into these teams to a limited degree however, particularly within FHTs. Perceptions of family physicians and nurse practitioners unanimously described the benefit of including PTs within PHC teams, particularly in the areas of musculoskeletal health and chronic disease management. Finally, PTs within PHC teams were found to enact five inter-related roles: manager, evaluator, collaborator, educator and advocate. The enactment of these roles were found to be impacted by three contexts: interprofessional team, community and population served, and organizational structure and funding. Overall, the findings support the inclusion of PTs within Ontario PHC teams. In addition to describing the areas of practice and specific roles relative to PTs contribution within Ontario PHC teams, this inquiry also explained how PTs enacted these roles. Further, this program of research articulated how the three above noted contexts impact how PTs practice in order to fulfill Ontario’s PHC mandate.


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