Electronic Thesis and Dissertation Repository

Thesis Format

Monograph

Degree

Master of Science

Program

Health and Rehabilitation Sciences

Supervisor

Doralp, Samantha

2nd Supervisor

Bryant, Dianne

Co-Supervisor

Abstract

Virtual pelvic physiotherapy (VPP) has emerged as a valuable adjunct to in-person care. However, there is an inadequate understanding concerning barriers and facilitators associated with the uptake and delivery of VPP. Using qualitative descriptive methodology and semi structured interviews, this study explored the potential barriers, facilitators and preferences from the experiences of pelvic physiotherapists delivering virtual care. An overall positive experience with VPP was reported by providers. Facilitators included improved opportunities for collaboration and patient education, patient-centered care and positive perceptions of clients and providers regarding VPP. Barriers included inaccessibility to a private space and technology, connectivity challenges and clients’ inadequate knowledge concerning VPP sessions. The preferences of clients and providers were also found to influence their uptake and implementation of VPP care. Potential disparities in VPP and the need to address them, to enhance the future delivery of VPP care are highlighted referencing the Digital Health Equity Framework (DHEF).

Summary for Lay Audience

The uptake of health services delivered via a digital platform, referred to here as virtual care, has recently seen an increase across all health disciplines, including physiotherapy. Literature focused on pelvic physiotherapy suggests that barriers already exist with respect to accessing pelvic physiotherapy in-person, with evidence to suggest that. Virtual options potentially increase access to services. Given that, there are limited studies exploring barriers and facilitators in the delivery of virtual pelvic physiotherapy. Much more needs to be understood about the experiences of those involved. Understanding the structure of these sessions, as well as different aspects of the delivery of virtual pelvic physiotherapy are important and can ultimately contribute to the improvement in the delivery of these services. This study aimed to explore the experiences of pelvic physiotherapists delivering virtual services and identify challenges, facilitators, preferences of providers, as well as any potential disparities in the provision of virtual pelvic physiotherapy. Using one-to-one interviews with pelvic physiotherapists, we discovered important themes pertaining to their overall experience with VPP. Pelvic physiotherapists reported an overall positive experience with VPP and identified several factors contributing toward its success. Moreover, participants also identified key facilitators including increased opportunities for patient education, improved collaboration with other healthcare professionals, VPP enhancing patient centered care and the positive beliefs and perceptions of clients and providers as significant factors facilitating the uptake of VPP care. Barriers to VPP care included clients not having access to a private space or relevant technology to access VPP sessions. Participants also identified that clients’ lack of awareness about the format and potential benefits of VPP may pose as a potential barrier to receiving VPP care. The preferences of pelvic physiotherapists and their clients were mostly for in-person care while they acknowledged VPP as a valuable adjunct to in-person care. These preferences also highlighted some potential biases. Furthermore, underlying discrepancies in VPP care were also uncovered. This work is significant in informing future delivery of virtual pelvic physiotherapy care so that necessary steps are taken to overcome the identified barriers and changes are made to further improve the VPP services for clients.

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