RESEARCH REPORT PLATFORM PRESENTATION

AN EXPLORATION OF HOW PHYSIOTHERAPY AFFECTS THE SOCIAL INCLUSION OF PERSONS WITH RA. Areskoug-Josefsson K; Värnamo Sjukhus, 331 85 Värnamo, Sweden

PURPOSE: To explore patients opinions of how physiotherapy affects patients with RA from the perspective of the relational model of social theory which considers Body, Work, Citizenship, Identity and Territory to determine if physiotherapy can enhance social inclusion RELEVANCE: The aim of physiotherapy intervention is to maximise independence and mobility. An ability to work is a primary concern for persons with RA. In order to measure the outcome of physiotherapy and to evaluate treatment effect it is important to bring forward the view of the patient. PARTICIPANTS: A consecutive selection of 8 persons with a diagnosed RA (ACR criteria) >4 years, who did not have any other chronic illness and who were permanent residents of the same geographical region. Each, during their period of illness, had participated in more than ten physiotherapy treatment sessions. Each gave written consent to participate in the project. METHODS: A phenomenological qualitative study design was used which facilitated data collection to establish views on whether treatment has an effect on social inclusion. Semi-structured interviews were chosen to allow the interviewer to probe the experience of the participant. They were conversational in style and focused onto the participant’s experience and views of the effect of physiotherapy. ANALYSIS: Each interview was tape-recorded and transcribed verbatim. The interviews were analysed within a phenomenological framework based on the role of physiotherapy concerning social inclusion, the categories were sorted into the five dimensions of the relational model of social theory. Data were sorted into categories concerning the phenomena of “effect of physiotherapy” and “effect of RA” on social activities. In this process two subgroups of “the role of the physiotherapist” and “physiotherapy in the future” emerged. Each of the four perspectives included the five dimensions of the relational model: body, work, citizenship, identity, and territory, and were integrated into an explanatory model. RESULTS: These participants experiences physiotherapy in group training as giving a positive effect on the perspective of citizenship and on identity, particularly after physical training, and increase self esteem. Ability to work was connected with independence. Physiotherapy played an active and important role in giving self-managing strategies, and providing social contact in training groups. The role of the physiotherapist was seen to be a motivator of physical activity and self-management strategies. CONCLUSIONS: Informants experienced physiotherapy in a body perspective with effects on participation in their environment and their work. Physiotherapy can lead to increased quality of life through increased body function which might increase ability to work. IMPLICATIONS: The findings from this study could be of interest to other EU states since the participants of this study are similar (concerning gender, age, sick leave from work, and duration of illness) An increased knowledge of how the persons with RA experience the effect of physiotherapy is of interest concerning development of physiotherapy treatment strategies. KEYWORDS: Social inclusion. FUNDING ACKNOWLEDGEMENTS: This project achieved financial support from the regional organisation for persons with Rheumatoid Arthritis and from Futurum, Academy of Health, County of Jönköping, Sweden. CONTACT: kristina.areskoug@lj.se

ETHICS COMMITTEE: Ethical inspection by the standards of the local county (Jönköpings läns landsting; Sweden) and the University of Karlstad, Sweden.