Knowledge of knee osteoarthritis (OA) and its management options affects adherence to treatment, symptoms, and function. Many sociocultural differences exist between Jordan, as a representative of the Middle East, and the developed world which might influence the knowledge of the pathology and its impact on health. Objectives. To explore the knowledge of the pathology and the experience of people diagnosed with knee OA living in Jordan. Methods. Qualitative study design using a triangulation method of both focus groups and in-depth semistructured interviews. Fourteen participants were included (13 females and one male). One focus group and seven in-depth semistructured interviews were conducted. Discussions were audiotaped and transcribed. Framework analysis was used, and data were mapped to the International Classification of Functioning, Disability and Health framework. Results. The themes are as follows: (1) body functions and structures included two subthemes: physical changes and psychological impact; (2) activity limitation and participation restriction included three subthemes: factors influencing the activities, cultural and social perspectives to activity limitation, and participation restriction; (3) personal factors included three subthemes: knowledge and personal interpretation of disease process, knowledge of management options to relief symptoms, and influence of personal factors on activity and participation; and (4) environmental factors included three subthemes: service delivery process, ineffective communication across the care pathway, and facilitators and barriers. Conclusions. Knowledge of the disease was lacking as a consequence of inappropriate service delivery and culture. Activity limitations and participation restrictions are similar in Jordan to other cultures in addition to limitations in religious, employment, and transportation activities. The results demonstrate that the effect of knee OA varies among different cultures and highlight the role of healthcare professionals worldwide in understanding the impact of culture on health. They also increase the awareness of healthcare professionals, specifically in Jordan, on the limitations in delivered services and the importance of education.
20 February 2020 in Physiotherapy Theory and Practice
Background: Culture and lifestyle could justify the variability in clinical patterns of knee osteoarthritis (OA) and was reported to affect exercise adherence. Objective: To explore perceptions and aspects influencing exercise adherence in people with knee OA in Jordan (a developing country) as they might be different from those reported in the developed world. Methods: Fourteen participants were included in the study (13 females, one male). One focus group and seven in depth semi-structured interviews were conducted. The discussions were audio-taped and transcribed. Framework analysis was used and data were interpreted using the socio-ecological model. Results: At the individual level, knowledge of the role of exercise in knee OA and personal factors influenced exercise performance and adherence. At the sociocultural level, cultural attitudes and beliefs and social interaction affected exercises adherence. At the organizational/political level, suboptimal service delivery process, inappropriate delivery of home exercises, accessibility of services affected exercise adherence. Opportunities for improving service delivery were also reported. At the environmental level, geography and weather affected adherence. Conclusions: Understanding the interaction of health-related behavior with individual, social/cultural, organizational, and environmental aspects would improve exercise adherence and equip physiotherapists with knowledge and resources to facilitate the implementation of patient-centered services.
Background: Community-based projects are an experiential learning tool that provides students with an opportunity to work within a team, to apply their skills and to learn in real workplace settings. Promoting physical activity is an important component of physiotherapy education, but the best method for training students to promote physical activity is open for discussion. Purpose: This study explored the attitudes and learning experiences of physiotherapy students who worked in groups to complete a community-based project involving the delivery of physical activity programs to a healthy population. Methods: Data were collected from a focus group of eight physiotherapy students each of whom had participated in a community-based project early in their studies. Results: Four themes emerged from the analysis of the data: 1) self-confidence and independence; 2) creativity and innovation; 3) effective communication; and 4) team dynamics. The students had positive attitudes toward community-based projects and reported that their experiences were a highly valued component of their early practice-based learning. The findings of this study are expected to encourage educators to use community-based projects early in undergraduate physiotherapy programs, as it helps students develop professional skills such as effective communication, creativity, and innovation. Students also learned to innovate to solve real-world problems in the workplace such as resource limitations. They also learned to appreciate the importance of team dynamics in a successful intervention. Conclusion: The findings suggest early participation in community-based projects is an excellent way for physiotherapy students to develop the competencies required for clinical practice and for their role in promoting physical activity.
This study aimed to explore factors associated with Physical Activity (PA) in Jordanian older people. Global Physical Activity Questionnaire was used to measure PA in 120 adults aged ≥ 60 years. Physical and psychosocial factors related to PA were measured including gait and balance, cognition, health-related quality of life, self-reported health, fear of falling and sociodemographic factors. Multiple linear regression analysis showed that longer sedentary time (Beta = −0.23, p = .009) and female gender (Beta = −0.36, p < .001) predicted lower PA. Use of walking aids (Beta = 0.21, p = .02) and poorer perceived general health (Beta = −0.25, p = .01) predicted longer sedentary time. Only small variance (adjusted R2 = 0.25 for PA and 0.22 for sedentary time, p < .001) was explained by the variables. Larger scale studies should explore cultural and environmental factors that could explain PA in this population.
The interplay between gender, Physical Activity (PA), and Dual Tasking (DT) in older adults is unclear. This study aimed to address DT based on gender and PA level. One-hundred and twenty older adults (81 women and 39 men) participated. Timed up and go test and spatiotemporal gait measures were collected in single and DT conditions. Participants were grouped according to gender and PA level. Physical activity did not explain gender differences, women were slower and had shorter stride lengths when DT regardless of PA level. Findings indicate the necessity for tailored PA and functional interventions to improve women’s performance.
The use of the International Classification of Functioning, Disability and Health (ICF) as a framework to scaffold students' clinical reasoning is recommended to address the multifactorial context of service delivery and complexities of health issues. However the application of the ICF in clinical reasoning is still not optimal due to personal and institutional factors. To train students to use the ICF in clinical reasoning, we need to understand both the students’ and the educators' perspectives on its use as a framework. The purpose was to explore and compare perspectives of physiotherapy educators and graduates toward applying clinical reasoning using the ICF as a framework. a qualitative approach adopting interpretive research paradigms was employed to understand how educators and graduates perceive the use of ICF in clinical reasoning. Two focus groups were used for data collection. Six graduates and five educators participated in the study. We identified five common themes between educators and graduates that described how the application of the ICF shaped clinical reasoning during students’ final year of study. These themes represent different approaches toward practicing clinical reasoning using the ICF, namely; critical thinking, workplace environment, holistic, activity and participation, and patient-centered. results revealed that the use of the ICF in clinical reasoning helped students develop contextual awareness and adopt a holistic and patient-centered approach. Some challenges like unsupportive workplaces were reported by both educators and graduates which hindered the use of the ICF in clinical reasoning. Another challenge reported by graduates and having a negative impact on their learning was different expectations from educators.