| dc.description.abstract | Background: Physiotherapists are involved in the management of patients in the
cardiothoracic Intensive Care Unit (ICU). Patient and family perception of care has become
an important measure in evaluating the quality of care, including care in the intensive care
setting.
Overall Aim: To explore and describe the family and patient perception of physiotherapy
care rendered in a public sector cardiothoracic ICU in the Western Cape, South Africa.
Method: This study was conducted in two phases. Phase 1 (scoping review) identified and
described available outcomes for measuring family perception of ICU care by searching six
databases from inception to the 20th June 2018. Results from the scoping review informed the
discussion schedule for the first primary study of Phase 2. Phase 2 (two exploratory
descriptive qualitative primary studies) explored and described i) family perception and ii)
patient perception of physiotherapy care in a cardiothoracic ICU. Audio-taped, individual
face to face semi-structured interviews were conducted with family and patient participants
that met the inclusion and exclusion sampling criteria (purposive sampling). Data was
transcribed verbatim and analysed using deductive-inductive thematic content analysis. The
data was coded, categorised and themes were generated. Trustworthiness of the data was
ensured through methods addressing credibility, dependability, confirmability and
transferability.
Results: A total of ten full text studies were included in the scoping review. Included studies
were published between 2006 and 2017, were conducted in both developed and developing
countries, in different ICUs (except cardiothoracic ICU)and all used different quantitative
outcome measures to measure family perception of ICU care. Thirteen cardiothoracic ICU patients and their respective family members partook in the
studies describing patient and family perception of cardiothoracic ICU physiotherapy care.
The median patient age was 62 years; the mean ICU length of stay 6 days and the median
family age was 55. Themes arising from the family perception of care data analysed included:
i) understanding of physiotherapy care (the role of the physiotherapist, perceived benefit of
physiotherapy and communication), family involvement in physiotherapy care (physical
presence during physiotherapy sessions and decision-making), and satisfaction of
physiotherapy ICU care. Themes arising from patient perception of care data analysed
included: i) Physiotherapy management of patients, ii) The Physiotherapists – skill, iii)
knowledge and professionalism, iv) Continuity of Care, v) Tangibility, vi) Physiotherapy
benefits, vii) Decision-Making, viii) Communication, ix) Satisfaction of Physiotherapy ICU
care.
Overall, family and patients were satisfied with the physiotherapy care in the cardiothoracic
ICU. However, there were areas of improvement such as the understanding of physiotherapy
care, communication, family involvement in the physiotherapy care and decision-making.
Conclusion: While there are multiple quantitative measures for measuring family perception
of ICU care there is no “gold” standard measure that has been identified. A qualitative
measure and research design would allow richer in-depth information on family perception of
ICU care. The findings from the family and patient perception of cardiothoracic ICU
physiotherapy care are influenced by many factors. While family and patients perceive
cardiothoracic ICU physiotherapy care both positively and negatively, the majority of patient
and family were satisfied overall with the care the patient received. Family perception of ICU
physiotherapy care should be evaluated in order to identify areas for improvement in quality
of care and could add to the body of evidence in ICU physiotherapy practice. | en_US |
