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Introducing Mechanically Assisted Cough for Patients with Progressive Neurological Disease : Patient-Physical Therapist Interaction and Physical Therapist Perspective

Andersson-Watz, Anna, 1980- (author)
Örebro universitet,Institutionen för medicinska vetenskaper,University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
Nygren-Bonnier, Malin (author)
Karolinska Institutet
Bergdahl, Elisabeth, 1962- (author)
Örebro universitet,Institutionen för hälsovetenskaper
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Eriksson Crommert, Martin, 1974- (author)
Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,University Health Care Research Center
Svantesson, Mia, 1960- (author)
Örebro universitet,Institutionen för hälsovetenskaper,Region Örebro län,University Health Care Research Center
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 (creator_code:org_t)
Oxford University Press, 2024
2024
English.
In: Physical Therapy. - : Oxford University Press. - 0031-9023 .- 1538-6724.
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • OBJECTIVE: The goal of this study was to explore patient-physical therapist interaction and the physical therapist's experience of the introductory session for mechanical insufflation-exsufflation (MI-E) device treatment for patients with progressive neurological disease.METHODS: Qualitative content analysis of participant-observation of interaction between patients and physical therapists during 9 MI-E introduction sessions in different clinical care settings and 10 follow-up interviews with 6 physical therapists.RESULTS: The introduction of MI-E emerged as a process of instilling a sense of security in the patient. The process can be described in 4 steps: (1) gain understanding by being responsive to the person's whole life-situation; (2) share knowledge and expectations in a respectful and permissive way; (3) introduce the device in a gentle and reciprocal interactivity; and (4) adapt to home-use in an inclusive dialogue with the patient and their significant others. Physical therapists described a need for assurance to instill a sense of security in the patient, implying a need for confidence, competent peers, guiding yet flexible routines, and emotional support.CONCLUSION: Physical therapists have a need to foster assurance in employing a person-centered approach to make a patient feel secure in the process of introducing MI-E treatment. Multiple modes of professional knowledge were used together with action-based and relational-based ethics to facilitate a person-centered care approach. This seems to be a promising approach for providing good care when introducing MI-E to patients. Further research is needed to explore this from the patient's perspective.IMPACT: This study added to the body of knowledge regarding MI-E treatment in relation to patients. This has direct implication, particularly for inexperienced physical therapists, for informed care for the patient during introduction. Our study also supports that person-centered care should be implemented at all levels of health care to make it possible for physical therapists to practice person-centered care.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Omvårdnad (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Nursing (hsv//eng)

Keyword

Mechanical Insufflation-Exsufflation
Neuromuscular Disease
Physical Therapy
Qualitative

Publication and Content Type

ref (subject category)
art (subject category)

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