Article

Integrated models of care are recommended for people with knee
osteoarthritis (OA). Exercise is integral to management, yet exercise adherence
is problematic. Telephone-based health coaching is an attractive adjunct to
physical therapist-prescribed exercise that may improve adherence. Little is
known about the perceptions and interpretations of physical therapists, telephone
coaches, and patients engaged in this model of care.
The purpose of
this study was to explore how stakeholders (physical therapists, telephone
coaches, and patients) experienced, and made sense of, being involved in an
integrated program of physical therapist-supervised exercise and telephone
coaching for people with knee OA. DESIGN: A cross-sectional qualitative design
drawing from symbolic interactionism was used. METHODS:
Semistructured interviews
with 10 physical therapists, 4 telephone coaches, and 6 patients with painful
knee OA. Interviews were audiorecorded, transcribed, and analyzed using thematic
analysis informed by grounded theory. RESULTS: Four themes emerged: (1) genuine
interest and collaboration, (2) information and accountability, (3) program
structure, and (4) roles and communication in teamwork. Patients reported they
appreciated personalized, genuine interest from therapists and coaches and were
aware of their complementary roles. A collaborative approach, with defined roles
and communication strategies, was identified as important for effectiveness. All
participants highlighted the importance of sharing information, monitoring, and
being accountable to others. Coaches found the lack of face-to-face contact with
patients hampered relationship building. Therapists and coaches referred to the
importance of teamwork in delivering the intervention. LIMITATIONS: The small
number of physical therapists and telephone coaches who delivered the
intervention may have been biased toward favorable experiences with the
intervention and may not be representative of their respective professions.
CONCLUSIONS: Integrated physical therapy and telephone coaching was perceived as
beneficial by most stakeholders. Programs should be structured but have some
flexibility to give therapists and coaches some freedom to adjust treatment to
individual patient needs as required. Opportunities for visual communication
between telephone coaches and patients could facilitate relationship building.
CI - (c) 2016 American Physical Therapy Association.

Langue : ANGLAIS