Clinicians' perspectives on remote patient management: A qualitative exploration of physiotherapists using the DiAL (Direct Access Line) programme.

BACKGROUND: In response to the COVID-19 pandemic, face-to-face consultations within healthcare settings were suspended. Remote consultations became crucial for managing musculoskeletal conditions alongside Patient Initiated Follow-ups, leading to the development of the DiAL programme at a large National Health Service Community Trust. Previous research has focused on quantitative data, little is known about staff experiences with this programme. OBJECTIVES: To explore the perceptions and opinions of physiotherapy staff using DiAL, in order to highlight the benefits and challenges of this service with identification of areas for future development. DESIGN: Qualitative focus groups. METHODS: Two virtual focus groups were conducted via Microsoft Teams, involving a purposive sample of physiotherapy staff in the musculoskeletal services known to have used DiAL. Thematic analysis was conducted. RESULTS: Ten clinicians participated in the study, generating two main themes: Clinician Autonomy and Institutional Needs. These themes encompassed several subthemes. CONCLUSIONS: Clinicians reported higher job satisfaction and improved accessibility for patients, attributing these positive outcomes to the autonomy and flexibility provided by the platform. While the programme met National Health Service targets for Patient Initiated Follow-ups, there was a desire for ongoing improvements and a recognition that previous audits failed to capture all the benefits. DiAL serves as a treatment choice, supporting evidence on the advantages of remote consultations and contributing to the National Health Services' goal of reducing its carbon footprint. There is a collective desire for the platform to continue with future recommendations including expanding its use and exploring additional audit metrics.

How do Employees with Chronic Musculoskeletal Disorders Experience the Management of Their Condition in the Workplace? A Metasynthesis.

This metasynthesis contributes to an understanding of the experiences, perceptions, and attitudes of employees on managing chronic musculoskeletal disorders (CMSDs) at work. Many studies in this field are concerned with prevention or return-to-work (RTW) programmes. However, the purpose of this review was to synthesise evidence that only focuses on the employees' management of their CMSDs at work. The SPIDER framework was used to structure the question "How do employees with CMSDs experience the management of their condition in the workplace"? The literature search focused on articles published between 2011 and 2021, and the search was conducted using the following databases: MEDLINE, SCOPUS, CINAHL, AMED, PsycINFO. The review identified nine articles that explored employees' experiences of managing CMSDs at work. Thematic synthesis was used to create analytic themes which provided a more in-depth discussion of these experiences. The identified themes were: 'employees actively seek ways to manage their conditions', 'influence of work environment on employees with CMSDs' and 'optimising the relationship between employees and managers. This metasynthesis suggests that the ability to negotiate workplace support and manage CMSDs at work is influenced by the cultural and social environment of the organisation. Effective communication, care and trust between the employee is needed. The review also illustrated the need for healthcare professionals to provide support to employees at work.

The concept of integration in mixed methods research: a step-by-step guide using an example study in physiotherapy.

BACKGROUND: Integration is a unique attribute of Mixed Methods Research (MMR). However, some MMR studies, published in the field of physiotherapy and other allied health professions, have illustrated a lack of understanding of the concept of integration. AIMS: The purpose of this paper is to provide guidance for integrating elements of mixed methods research in order to effectively support evidence-based practice in health. METHODS: The concept of integration of findings is explained with reference to the author's recent PhD study, which used a mixed methods exploratory sequential design. This article describes how the author used a narrative joint display to integrate findings from both the qualitative and survey phases of the study. Then, a step-by-step approach is introduced to guide the interpretation and integration of the findings. RESULTS: This four-step approach demonstrates integration of the two different datasets: Creating a joint display, linking activity, establishing relationships, and interpreting and reporting. Tables and Figures are used to support detailed description and illustration of the integration process. DISCUSSION: A joint display provides a visual representation of how the qualitative and quantitative findings in a MMR study can be integrated. In this way, interpretation of the data drawn from this process extend beyond the individual findings of each study component to facilitate a greater understanding of complex health care issues.

Management of Chronic Musculoskeletal Disorders in the Workplace from the Perspective of Older Employees: A Mixed Methods Research Study.

(1) Background: This mixed methods research (MMR) study explored older employees' experiences of chronic musculoskeletal disorders (CMSDs) in relation to their employment, their perspectives on managing these conditions in the workplace and the strategies used to facilitate and maintain their roles and responsibilities. The services offered to them were also identified. (2) Methods: A mixed methods exploratory sequential design was implemented. In the first qualitative phase, 16 semi-structured interviews gathered in-depth information from older employees. The findings informed the development of an online questionnaire in the survey phase, which was administered to older employees (N = 107). Both sets of findings were then integrated using a narrative joint display. (3) Results: The phenomena of presenteeism and leaveism were important components of employees' strategies for managing their condition. The integrated findings highlighted the roles of employers, managers and social support in encouraging disclosure and supporting the management of CMSDs. The results also emphasised how self-management and professional health services are crucial for sustaining employability. (4) Conclusions: Current challenges call for employers to identify effective ways to support the ageing workforce and invest in training opportunities for managers and collaborative opportunities with healthcare professionals and other stakeholders. A flexible, empathetic and resourceful work environment is optimal for supporting sustained employability for an ageing workforce.

A systematic review on workplace interventions to manage chronic musculoskeletal conditions.

BACKGROUND AND PURPOSE: A review to investigate whether there are effective workplace interventions that manage chronic musculoskeletal disorders. METHODS: The literature search included published articles between 2008 and 2017. The databases used in this search were MEDLINE, Scopus, CINAHL, AMED, PsycINFO, Academic Search Complete, Cochrane, and PEDro. A limited search on websites for relevant grey literature was also conducted. RESULTS: The review included 12 studies that investigated effectiveness of a specific strength exercise programme or interventions provided by health professionals at the workplace when compared with controls or interventions not at the workplace. Seven studies were classified as high quality (>85% of criteria met) and five studies were classified as acceptable. Studies were heterogeneous preventing a meta-analysis. No intervention was clearly superior to another. DISCUSSION: There was some consistency in the results of the selected studies, suggesting that workplace interventions such as high-intensity strength exercises and/or integrated health care can decrease pain and symptoms for employees who experience long-term musculoskeletal disorders. However, the current research is limited.

Injury Surveillance of Nonprofessional Salsa Dance.

BACKGROUND: The investigation sought to (1) establish the extent of injuries, (2) determine the odds of sustaining an injury, and (3) calculate the injury incidence rate in nonprofessional salsa dance. METHODS: Salsa dancers completed an anonymous web-based survey containing 11 demographic background and 10 (1 y retrospective) injury history questions. RESULTS: The response rate was 77%. The final sample of respondents included 303 women and 147 men, of which 22% and 14%, respectively, sustained ≥1 injury during salsa dance in the past year. The odds of injury was 2.00 (95% confidence interval [CI], 1.14-3.50) times greater (P < .05) for women than for men. Age, body mass index, and salsa dance experience were also found to be significant (all Ps < .05) predictors of injury. The injury incidence rate for women and men was 1.1 (95% CI, 0.9-1.4) and 0.5 (95% CI, 0.3-0.7) injuries per 1000 hours of exposure, respectively. CONCLUSIONS: This is the first study to have described salsa dancers in terms of their injury history profile. Results indicate that the likelihood of sustaining an injury during this physical activity is similar to that of ballroom, but lower than that of Spanish, aerobic, and Zumba®, dance.