Electronic Thesis and Dissertation Repository

Thesis Format

Monograph

Degree

Master of Science

Program

Health and Rehabilitation Sciences

Supervisor

Walton, Dave

Abstract

Patient-centered care (PCC) is a growing standard for healthcare delivery due to the benefits to patient autonomy. Lacking a cohesive definition in the physiotherapy literature, it is also lacking in implementation. Employing interpretive description with semi-structured interviews, the goal was to understand how physiotherapists drawn from private for-profit clinics in Canada describe PCC, and barriers and facilitators to providing it. Results included requiring person-centered communication in PCC, seeing Health holistically, centering the patient in care, and being a skill that becomes clearer with practice experience. Barriers included: lack of practitioner reflexivity, patient not desiring self-directed care, and limited access to interprofessional care. Facilitators included: time available with patient, practice community support, learning from experience, continued education, and practitioner emotional resilience. Results display how PCC is described by participants from private physiotherapy care in Canada, and inform us on further exploration around how to best facilitated PCC in Canada.

Summary for Lay Audience

Healthcare has traditionally been very provider-centric in its delivery. Care is provided to the patient in a way that keeps authority and power in the hands of the one providing the care. There has been increased movement in the last several decades to provide healthcare in all fields that is more centered on the patient. This means increasing the patient’s voice in discussion with the medical professional, and shifting the professional’s focus from “curing” a disease or repairing an injury to restoring the patient’s ability to lead a meaningful life and function as they want. In this project, we investigated how this concept of “patient-centered care” (PCC) was seen by physiotherapists, as this is a field where implementation of the practice seems to be lacking. We also investigate factors they see as preventing them or assisting them in providing PCC. Using interviews and discussions with participants, several themes were uncovered including the importance of communication strategies that centered the patient, taking a deeper, broader view of a patient’s health, and ensuring the patient was centered in the care. Barriers included practicing physiotherapy without being self-aware of your own biases and opinions, the patient not desiring self-directed care, and limited access to other healthcare resources when the patient was in need. Facilitators included the time available under the physiotherapy model of care, the availability of support from other physiotherapists around them, learning from experience or further education, and possessing strength in regard to listening and empathizing with patients over concerns and struggles. The results of this work are useful in helping to guide and inform future work that will help paint a more definitive picture of the experience of providing patient-centered care that physiotherapists live; showing policy makers ways in which they can assist and teach physiotherapists in providing the best possible care.

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