Rollen im Kontext: Interaktion während Physiotherapie in der Schlaganfallrehabilitation

Zusammenfassung

Hintergrund: Die Schlaganfallrehabilitation ist ein komplexer Vorgang. Bei der Physiotherapie wurden die Perspektiven der beteiligten Parteien bisher wenig beachtet.

Ziel: Das Ziel der Studie bestand darin, qualitative Studien zu Physiotherapie bei Schlaganfallrehabilitation mit besonderer Berücksichtigung der Interaktion zu untersuchen.

Methode: Anhand einer Schlüsselwörtersuche in 8 Datenbanken wurden 4 Studien gefunden. Weitere 14 Studien ergaben sich mittels Handsuche.

Ergebnisse:Übliche Themen der qualitativen Forschung zu Physiotherapie in der Schlaganfallrehabilitation waren: Rollen einschließlich Verhalten und Einstellungen, Kontext, Kommunikation einschließlich Interaktion, Informationsaustausch und Anweisungen sowie Zielsetzung. Wenn Patienten und Physiotherapeuten die Rehabilitation beschreiben, ist vordergründig Übereinstimmung zu erkennen. Geht es jedoch um Aspekte der Gewährleistung der Behandlungsqualität, besteht wenig Einheitlichkeit. Interaktionsmuster waren hauptsächlich durch hierarchische Strukturen gekennzeichnet. Es zeigte sich aber, dass sich diese Interaktionsmuster durch Kontextfaktoren, Einstellungen und Handlungen ändern ließen. Des Weiteren wurde eine Diskrepanz zwischen den Einstellungen von Physiotherapeuten und ihrer klinischen Praxis festgestellt. Die Auswirkungen auf die Arbeit der Physiotherapeuten werden aufgezeigt.

Schlussfolgerungen:Angesichts eines derart komplexen Phänomens wie Schlaganfall muss der gegenwärtige Ablauf von Physiotherapie zur Schlaganfallrehabilitation überdacht und weiter erforscht werden. Themen wie Rollen, Kontext, Kommunikation und Zielsetzung in der Physiotherapie sollten Gegenstand von Ausbildung und beruflicher Weiterbildung werden, um die Behandlungsqualität für Patienten mit Schlaganfall zu verbessern.

Abstract

Background: Stroke rehabilitation is a complex process and with regard to physiotherapy, little attention has been paid to the perspectives of the parties involved.

Objective: The aim of the study was to review qualitative studies of physiotherapy in stroke rehabilitation with special regard to interaction.

Method: 4 studies were identified by means of a search in 8 databases using key words. 14 additional 14 studies were identified by hand search.

Results: Topics common in qualitative research on physiotherapy in stroke rehabilitation were roles including behaviour and attitudes, context, communication including interaction, information exchange and instructions as well as goal setting. When patients and physiotherapists describe rehabilitation, there is superficial agreement but little consistency in aspects assuring treatment quality. Patterns of interaction were mainly characterized by hierarchy. However, the patterns of interaction were shown to be alterable by means of context factors, attitudes and actions. Another finding was a discrepancy between the physiotherapists’ attitudes and their clinical practice. The implications for the physiotherapists’ work are outlined.

Conclusion: In the light of a complex phenomenon such as stroke, the current process of physiotherapy in stroke rehabilitation requires reconsideration and future research. Education and professional development need to attend to issues like roles, context, communication and goal setting in physiotherapy in order to improve treatment quality for stroke patients.

Schlaganfallrehabilitation - qualitative Forschung - Physiotherapie - Interaktion - Kontext

stroke rehablitation - qualitative research - physiotherapy - interaction - context

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