All informants had clinical experience in the area of fall prevention and working with older adults.
#Micro meso and macro levels trial
The current study was conducted in six municipalities in Eastern Norway, where the participating PTs had earlier been involved in a randomised controlled trial evaluating a fall preventative exercise programme. To answer the research question, we used a purposive sample, which are used when the opinion of experts in a particular field is the topic of interest. The consolidated criteria for reporting qualitative research (COREQ) were used to guide the reporting of the current study. The goal of a phenomenological perspective is to summarise individual experiences and provide descriptions that include ‘what’ people experience and ‘how’ they experience it. The current study used a qualitative design with a phenomenological perspective. Hence, the present study aimed to explore PTs’ view of how they experience and perceive their role in preventing falls in the primary care setting. To foster higher levels of consciousness about fall prevention among those at risk, more qualitative research can provide a deeper understanding of the development and experience of fall prevention work. Previous research has shown that the most powerful means of preventing falls is exercise, and PTs often provide this type of intervention, playing a significant role in fall prevention. In many Western countries therefore, politicians engage with this topic.
#Micro meso and macro levels professional
However, fall prevention is an important topic for a variety of professional groups working with PTs, such as PTs assistants occupational therapists, nurses and physicians. Because falls are multifactorial, fall prevention also must address biopsychosocial characteristics such as age, history of previous falls, health conditions, polypharmacy, pain, fear of falling, self-efficacy for exercise and social support. Several systematic reviews and meta-analyses have stated that exercise is one of the most powerful ways to prevent falls and that physiotherapists (PTs) play a multifaceted role in this context. There is robust evidence that exercise can reduce falls in the older population. Every year, 30% of community-dwelling older people experience a fall, and falls are a leading cause of morbidity, mortality, functional disability, hospitalisation and institutionalisation in older adults. The PTs saw the need for working at the micro-, meso- and macro-levels to succeed in the work of fall prevention.įalls pose a major threat to the well-being and quality of life of older people and have become one of the most important global public health concerns for community-dwelling older people and society in general. Attention should be placed on the importance of biopsychosocial perspective framing in the actual clinical and political context. To ensure good quality the PTs focused on the special needs of the patients, evidence-based fall prevention, interdisciplinary team work, good clinical competences, good skills in communication, and interpersonal relations. Our findings indicate that the PTs’ role reflects their abilities to change and improve their professional work in accordance with evidence based knowledge. Success in the role of physiotherapists in fall prevention depends on the empowering leadership and working culture, as well as on the time and multifaceted professional competence of the clinicians. The three themes were as follows: 1) always moving and changing: the competent explorative knowledge-hungry clinician’s multifaceted role 2) multiprofessional – but in the end alone 3) reaching out – from the bottom to the top. A key factor for this role is to take an integrative biopsychosocial approach based on how biological and psychosocial factors are uniquely related in fall prevention. The core theme was ‘capability to cope with the tensions between the micro-, meso- and macro-levels in fall, prevention’, which indicated the importance of an evolving multifaceted, evidence based and innovative physiotherapy role. The analysis resulted in a core theme and three subthemes. Data were analysed using a qualitative thematic analysis. Semi-structured interviews were conducted with 17 physiotherapists.
Therefore, the purpose of the present study is to explore physical therapists’ (PTs) view of how they experience and perceive their role working with fall prevention in a community care setting. Physiotherapists are a key resource in this context, but there is sparse knowledge about how they perceive their role in the primary care setting. Falls are a global public health concern.
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