Physiotherapy palliative cancer care: a case study approach.

Abstract

There is evidence to suggest that the role of the allied health professional continues to evolve in the delivery of palliative cancer care services. Whilst it appears that there is an increasing need for physiotherapists, there is a lack of understanding about the nature of their role, their educational needs and their place within the rehabilitation team. The aim of my work was to explore a local palliative cancer care physiotherapy service provision in the light of best practice recommendations, using both my own practice development and a research study. For my research a qualitative approach using a single case study design was chosen as it provided a framework to facilitate the inclusion of multiple perspectives in a complex context within an area of healthcare where little research has been undertaken. Multiple methods of data collection were used from numerous perspectives, which included four data sets: interviews (healthcare professionals [10]); interviews (service users [10]); observations (physiotherapists [2] treating service users [5]); and policy document collection (NICE guidelines; white papers [12]). Detailed data analysis was then carried out using a thematic approach within a framework, comparing and contrasting patterns within and across the four data sets. Emergent themes highlighted a number of important aspects relating to physiotherapists including: new ways of working, shift in mindset and treatment planning, emotional adjustment and integration of professional boundaries. My primary research and practice development project combined to evidence the metamorphosis of both the physiotherapist profession and service provision where competencies around mentorship, entrepreneurship, leadership, policy championship, integrated teamwork, humanisation and self-reflection embodied within the psycho-social-cultural-spiritual model of healthcare enabled them to meet key policy recommendations of service quality and innovation. A debate is necessary around the need for profession specific or service specific outcomes in this area, and how physiotherapists ‘prove their worth’ now that they are an integral part of palliative cancer care provision.