Be a physiotherapist during Covid-19: a grounded theory study: Covid-19 experience: qualitative study among physiotherapists

Emanuela Ricci; Lorena Menta; Filomena Simeone; Gianfranco Lamberti; Vittorio Casati; Gianluca Ciardi

doi:10.23750/abm.v95i1.15627

Be a physiotherapist during Covid-19: a grounded theory study

Covid-19 experience: qualitative study among physiotherapists

Authors

Emanuela Ricci Department of Rehabilitative Medicine, Azienda Usl Piacenza; Degree course of Physiotherapy, University of Parma
Lorena Menta Azienda Usl Parma; Degree course of Physiotherapy, University of Parma
Filomena Simeone Department of Rehabilitative Medicine, Azienda Usl Piacenza; Degree course of Physiotherapy, University of Parma
Gianfranco Lamberti Department of Rehabilitative Medicine, Azienda Usl Piacenza; Degree course of Physiotherapy, University of Parma https://orcid.org/0000-0002-3288-5275
Vittorio Casati Department of Rehabilitative Medicine, Azienda Usl Piacenza
Gianluca Ciardi Department of Rehabilitative Medicine, Azienda Usl Piacenza; Degree course of Physiotherapy, University of Parma https://orcid.org/0000-0002-6062-2288

DOI: https://doi.org/10.23750/abm.v95i1.15627

Keywords:

Covid-19, Physiotherapist, lived experience, grounded theory, qualitative study

Abstract

Background and aim: Covid-19 pandemic posed a challenge to National Health Systems, both in terms of resources and working setup changes. Introduction of spacing, personal protective equipment, infection prevention measures forced healthcare professionals to change both work contexts and patient-operator and inter-operator relationship dynamics. The present qualitative study aimed to deepen the experience of physiotherapists working at AUSL in Piacenza. Methods: A constructivist grounded theory approach was employed. Initial sampling was achieved through a purposive strategy among physiotherapists working at Department of Rehabilitation Medicine at AUSL in Piacenza. They were firstly contacted by e-mail; for included professional a structured collection of nine audio diaries was employed in the first phase; semi structured interviews were then employed in order to reach data saturation. Data analysis was carried out using the Grounded theory, in order to build a theory based on emerging data. Results: Nine physical therapists accepted to participate; mean (±SD) age of the sample was 46,5 (range 33 to 60 years), and the majority of participants were female (77,8%). Each participant recorded an average of 7.5 audio diaries out of nine; all recruited physiotherapists were then interviewed. Conclusions: Theory that arises from data explains Covid-19 pandemic as a moment of personal and professional growth for physiotherapists, which changed their role by adding communication skills, new knowledge and the need of a multidisciplinary care for their patients, in a continuous process of one’s own role evolution.

References

Shah A, Kashyap R, Tosh P, Sampathkumar P, O’Horo JC. Guide to Understanding the 2019 Novel Coronavirus. Mayo Clin Proc. 2020 Apr;95(4):646–52. doi: 10.1016/j.mayocp.2020.02.003

Yesudhas D, Srivastava A, Gromiha MM. COVID-19 outbreak: history, mechanism, transmission, structural studies and therapeutics. Infection. 2020 Sep 4;49(2): 1-15. doi: 10.1007/s15010-020-01516-2.

Li H, Liu SM, Yu XH, Tang SL, Tang CK. Coronavirus disease 2019 (COVID-19): current status and future perspectives. Int J Antimicrob Agents 2020 May;55(5):105951. doi: 10.1016/j.ijantimicag.2020.105951.

Blumenthal D, Fowler EJ, Abrams M, Collins SR. Covid-19 — Implications for the Health Care System. N Engl J Med 2020; Jul 22;383(15). doi: 10.1056/NEJMsb2021088.

Luo M, Guo L, Yu M, Jiang W, Wang H. The psychological and mental impact of coronavirus disease 2019 (COVID-19) on medical staff and general public – A systematic review and meta-analysis. Psychiatry Res 2020; Sep 1; 291(113190):113190. doi: 10.1016/j.psychres.2020.113190.

Fernández‐Castillo R, González‐Caro M, Fernández‐García E, Porcel‐Gálvez A, Garnacho‐Montero J. Intensive care nurses’ experiences during the COVID ‐19 pandemic: A qualitative study. Nurs Crit Care 2021; Jan 5;26(5). doi: 10.1111/nicc.12589.

Gomez T, Anaya YB, Shih KJ, Tarn DM. A Qualitative Study of Primary Care Physicians’ Experiences With Telemedicine During COVID-19. J Am Board Fam Med 2021; Feb 1;34(Supplement): S61–70. doi: 10.3122/jabfm.2021.S1.200517.

Haq W, Said F, Batool S, Awais HM. Experience of physicians during COVID-19 in a developing country: a qualitative study of Pakistan. J Inf Dev Ctries 2021; Mar 7;15(02):191–7. doi: 10.3855/jidc.13954.

Bekker Mortensen C, Zachodnik J, Fjordbak Caspersen S, Geisler A. Healthcare professionals’ experiences during the initial stage of the COVID-19 pandemic in the ICU, a qualitative study. Intensive Crit Care Nurs 2021 Aug;68: 103130. doi: 10.1016/j.iccn.2021.103130.

Aughterson H, McKinlay A, Fancourt D, Burton A. Psychosocial impact on frontline health and social care professionals in the UK during the COVID-19 pandemic: a qualitative interview study.BMJ Open 2021; 11 (2): e047353. doi: 10.1136/bmjopen-2020-047353.

Danet Danet A. The psychological impact of the COVID-19 pandemic on Western frontline healthcare professionals. A systematic review. Med Clin (Barc) 2021; 156 (9): 449-58.

Julka-Anderson N. How COVID-19 Is Testing and Evolving Our Communication Skills. J Med Imaging Radiat Sci 2020; 51 (4S): S11-3. doi: 10.1016/j.medcli.2020.11.009.

Butler CR, Wong SPY, Vig EK, Neely CS, O'Hare AM. Professional roles and relationships during the COVID-19 pandemic: a qualitative study among US Clinicians. BMJ Open 2021; 25 (11): e047782. doi: 10.1136/bmjopen-2020-047782.

Catania G, Zanini M, Hayter M, Timmins S, Dasso N, Ottonello J, et al. Lessons from Italian frontline nurses' experiences during the COVID-19 pandemic: A qualitative descriptive study. J Nurs Manag 2021; 29(3): 404-11. doi: 10.1111/jonm.13194.

Gordon JM, Magbee T, Yoder LH. The experiences of critical care nurses caring for patients with COVID-19 during the 2020 pandemic: A qualitative study. App Nurs Res 2021; 59(6): 151418.doi: 10.1016/j.apnr.2021.151418.

Sheng Q, Zhang X, Wang X, Cai C. The influence of experiences of involvement in the COVID-19 rescue task on the professional identity among Chinese nurses: A qualitative study. J Nurs Manag 2020; 28 (n7): 1662-9. doi: 10.1111/jonm.13122.

Zhang Y, Wei L, Li H, Pan Y, Wang J, Li Q et al. The Psychological Change Process of Frontline Nurses Caring for Patients with COVID-19 During Its Outbreak. Issues Ment Health Nurs 2020; 41(6): 525-30. doi: 10.1080/01612840.2020.1752865.

Vindrola-Padros C, Andrews L, Dowrick A. Perceptions and experiences of healthcare workers during the COVID-19 pandemic in the UK. BMJ Open 2020; 10(11): e040503. doi: 10.1136/bmjopen-2020-040503.

Bennett P, Noble S, Johnston S, Jones D, Hunter R. COVID-19 confessions: a qualitative exploration of healthcare workers' experiences of working with COVID-19. BMJ Open 2020; 16 (10): 043949. doi: 10.1136/bmjopen-2020-043949.

Crowe S, Howard AF, Vanderspank-Wright B. The effect of COVID-19 pandemic on the mental health of Canadian critical care nurses providing patient care during the early phase pandemic: A mixed method study. Intensive Crit Care Nurs 2021; 63(4): 102999. doi: 10.1016/j.iccn.2020.102999.

Tanne JH, Hayasaki E, Zastrow M, Pulla P,Smith P, Garcia Rada A. Covid-19: how doctors and healthcare systems are tackling coronavirus worldwide. BMJ 2020; 368: m1090, 2020. doi: 10.1136/bmj.m1090.

Verhoeven V, Tsakitzidis G, Philips H, Van Royen P. Impact of the COVID-19 pandemic on the core functions of primary care: will the cure be worse than the disease? A qualitative interview study in Flemish GPs. BMJ Open 2020; 10 (6): e039674. doi: 10.1136/bmjopen-2020-039674.

Allen J, Gay B, Crebolder H, Heyrmann J, Svab I, Ram P. The European definitions of the key features of the discipline of general practice: the role of the GP and core competencies. Br J Gen Pract 2002; 52: 526–7.

Jette AM, Delany C, Lundberg M. The value of qualitative research in Physical Therapy. Phys Ther 2019; 99: 819–20. doi: 10.1093/ptj/pzz070.

Palacios-Ceña D, Fernández-de-Las-Peñas C, Palacios-Ceña M. Working on the Frontlines of the COVID-19 Pandemic: A Qualitative Study of Physical Therapists' Experience in Spain. Phys Ther 2021;101(4): pzab025. doi: 10.1093/ptj/pzab025.

Ditwiler RE, Swisher LL, Hardwick DD. Professional and Ethical Issues in United States Acute Care Physical Therapists Treating Patients With COVID-19: Stress, Walls, and Uncertainty. Phys Ther 2021; 101(8):pzab122. doi: 10.1093/ptj/pzab122.

Palacios-Ceña D, Fernández-de-Las-Peñas C, Florencio LL, de-la-Llave-Rincón AI, Palacios-Ceña M. Emotional Experience and Feelings during First COVID-19 Outbreak Perceived by Physical Therapists: A Qualitative Study in Madrid, Spain. Int J Environ Res Publ Health 2020; 27(18-s1): 127. doi: 10.3390/ijerph18010127.

Russo V, Cante L, Imbalzano E, Di Micco P, Bottino R, Carbone A, D'Andrea A. The Impact of COVID-19 Pandemic on Hospitalization and Interventional Procedures for Cardiovascular Diseases during the First Wave in Italy. Int J Environ Res Public Health. 2022 Dec 28;20(1):472.doi: 10.3390/ijerph20010472.

Colais P, Cascini S, Balducci M, et al. Impact of the COVID-19 pandemic on access to healthcare services amongst patients with multiple sclerosis in the Lazio region, Italy. Eur J Neurol. 2021 Oct;28(10):3403-3410. doi: 10.1111/ene.14879.

Caratozzolo S, Zucchelli A, Turla M, et al. The impact of COVID-19 on health status of home-dwelling elderly patients with dementia in East Lombardy, Italy: results from COVIDEM network. Aging Clin Exp Res. 2020 Oct;32(10):2133-2140. doi: 10.1007/s40520-020-01676-z.

Gimbe Foundation. Impact of Covid-19 Pandemics on provision of healthcare services. Available at: https://www.gimbe.org/osservatorio/Report_Osservatorio_GIMBE_2021.01_Impatto_COVID_19_prestazioni_sanitarie.pdf

Fernández-Lago H, Climent-Sanz C, Bravo C et al. Physiotherapists' experiences on assisting physiotherapy users during the COVID-19 pandemic with lockdown measures in Spain. Physiother Res Int. 2023 May 19;e2015. doi: 10.1002/pri.2015. Online ahead of print. doi: 10.1002/pri.2015.

Santacroce L, Bottalico L, Charitos IA. The Impact of COVID-19 on Italy: A Lesson for the Future. Int J Occup Environ Med. 2020 Jul 10;11(3):151-152. doi: 10.34172/ijoem.2020.1984.

Gerevini S. COVID-19: Northern Italy experience. Interv Neuroradiol. 2021 Oct;27(1_suppl):46-47. doi: 10.1177/15910199211035303.

Charmaz, K. (2016). Constructivist Grounded Theory. The Journal of Positive Psychology, 12(3), 299-300. doi: 10.1080/17439760.2016.1262612

Birks M, Mills J. Grounded theory: a practical guide. 2nd ed. London: SAGE, 2015.

Stinson JN, Petroz GC, Stevens BJ, Feldman BM, Streiner D, McGrath PJ et al. Working out the kinks: testing the feasibility of an electronic pain diary for adolescents with arthritis. Pain Res Manag. 2008 Sep-Oct;13(5):375-82. doi: 10.1155/2008/326389.

Stinson JN. Improving the assessment of pediatric chronic pain: harnessing the potential of electronic diaries. Pain Res Manag. 2009 Jan-Feb;14(1):59-64. doi: 10.1155/2009/915302.

Moretti V, Chakraborty A. Media Habits And Covid-19. Using Audio-Diaries Technique To Explore "Official" Information Consumption. Out of line, land, tourism technology. Sociology journal 2020; 7(1): 97-104. doi: 10.6092/2723-9608/7043

Lima Ribeiro D, Pompei Sacardo D, Jaarsma D, de Carvalho-Filho MA."Every day that I stay at home, it's another day blaming myself for not being at # Frontline"-Understanding medical students' sacrifices during COVID-19 Pandemic. Adv health sci educ Theory Pract 2022; 12: 1-21. doi: 10.1007/s10459-022-10192-w.

Parkin D, Rice N, Jacoby A, Doughty J. Use of a visual analog scale in a daily patient diary: modeling cross-sectional time-series data on health-related quality of life. Social Sci Med 2004; 59: 351-60. doi: 10.1016/j.socscimed.2003.10.015.

Migliorati L. A sociologist in the red zone. Risk, fear, death, and creativity during Covid-19. Milan:Franco Angeli; 2020

K. Charmax. "Grounded theory: objectivist and constructivist methods", in Denzin, N.K., Lincoln, Y.S. (eds) Handbook of Qualitative Research, 2000, Sage, London, pp 509-35

O'Brien BC, Harris IB, Beckman TJ, Reed DA, Cook DA. Standards for reporting qualitative research: a synthesis of recommendations. Acad Med. 2014;89(9):1245-1251. doi: 10.1097/ACM.0000000000000388.

Eftekhar Ardebili M, Naserbakht M, Bernstein C, Alazmani-Noodeh F, Hakimi H, Ranjbar H. Healthcare providers experience of working during the COVID-19 pandemic: A qualitative study. Am J Infect Control. 2021 May;49(5):547-554. doi: 10.1016/j.ajic.2020.10.001.

Ming Khoo EE, Abdullah A, May Liew S, et al. Psychological health and wellbeing of primary healthcare workers during COVID-19 pandemic in Malaysia: a longitudinal qualitative study. BMC Prim Care. 2022 Oct 13;23(1):261. doi: 10.1186/s12875-022-01870-0. doi: 10.1186/s12875-022-01870-0

Bozzolan M, Bighi E, Occhi A, et al. Professional practice, competence, and education related to COVID-19: A mixed-methods light study of physiotherapists' experiences. Physiother Theory Pract. 2022 Nov 11:1-17. doi: 10.1080/09593985.2022.2142083.

Campo M, Hyland M, Hansen R. Experiences of physical therapists during the COVID-19 pandemic: an interpretive phenomenological analysis. Physiother Theory Pract . 2023 Feb;39(2):369-383. doi: 10.1080/09593985.2021.2021576. Epub 2022 Jan 3. doi: 10.1080/09593985.2021.2021576.

Luo M, Guo L, Yu M, Jiang W, Wange H. The psychological and mental impact of coronavirus disease 2019 (COVID-19) on medical staff and general public – A systematic review and meta-analysis. Psychiatry Res 2020; 291:113190. doi: 10.1016/j.psychres.2020.113190.

Grailey K, Lound A, Brett S. Lived experiences of healthcare workers on the front line during the COVID-19 pandemic: a qualitative interview study. BMJ Open . 2021 Dec 30;11(12):e053680. doi: 10.1136/bmjopen-2021-053680. doi: 10.1136/bmjopen-2021-053680.

Ricœur P. Time and Narrative (Volume 1). University of Chicago Press: Chicago; 2020.

Smyth JM. Written emotional expression: Effect sizes, outcome types, and moderating variables. J Consult Clin Psychol 1998; 66(1): 174–84. doi: 10.1037//0022-006x.66.1.174.