P01 |
Pvt |
3 |
2 |
Y |
Con |
”…it comes down to the education these
days and less contact between the lecturers and the students…
some conditions slip through that these students don’t see at
all… they must be able to treat those conditions and so if they
can read up on what are the guidelines for these
conditions…” |
P02 |
Ed |
2 |
1 |
N |
Act |
“I don’t have much sympathy for the
arguments that there isn’t time. Change the narrative to not be
something in addition to what you are already doing but it’s part of
your practice… the best clinicians in the world who are not only also
loaded with patients, they still find time to attend conferences, to
publish, engage with the literature, develop guidelines… Are they
complaining about their case load? No, they have got time so why don’t
you have time” |
P03 |
Pvt |
1 |
2 |
Y |
Con |
”I think it does take a lot of extra
effort because it is extra reading that needs to go into it and
everything so it’s not always during the day, it’s almost forms part of
an extra part of the day or separate to the day’s work and then doing a
little bit of research and then implementing it in the clinical
setting…” |
P04 |
Pub |
2 |
1 |
Y |
P-con |
“I may have a very busy workload and
other commitments I might only be able to do four of the five aspects of
the guideline… there is a challenge when it comes to workload and
implementing a full guideline without hindering patient
care” |
P05 |
Pub |
1 |
2 |
Y |
P-con |
“…in my setting I have a big
load, so I won’t always use [CPGs] but I think there is a place for
specific patients” |
P06 |
Ed |
3 |
1 |
N |
Act |
“…that would help more than just
emailing someone a guideline and then they need to manoeuvre through the
guideline on their own… sometimes people don’t even know of the
availability of guidelines and so information workshops about guidelines
and the fact that guidelines need to be updated… it’s information
being provided, and I just need to think about how I could apply some of
this. people always see something new or different as extra work…how
one introduces a guideline is important…” |
P07 |
Ed |
2 |
2 |
N |
Prep |
“if you are sensitive when which
guideline is appropriate, it could actually ease your load…but if you
are only one clinician at a clinic where you have to do all the admin
and appointments…you don’t have time…” |
P08 |
Ed |
2 |
1 |
D |
Act |
”…I do use a clinical guideline on the
management of adhesive capsulitis within a third-year case that I
facilitate with the students… I’m always disappointed because they
don’t take up that information…” |
P09 |
Ed |
3 |
1 |
D |
Act |
”…I’ve never sat and worked with a
guideline and worked with the patient… I’ve just checked is that
in agreement with my approach…” |
P10 |
Ed |
2 |
1 |
Y |
P-con |
“…it is much more difficult to
actually have that extra time to maybe complete a health-related quality
of life questionnaire. the distribution of human resources because you
should actually have more people where the majority of patients are…
so there is a little more of equalisation. your daily interaction with
your patients because as soon as it can become sort of your habit of
dealing with the patient, it doesn’t become something like… I have to
do it because management forced us to do it” |
P11 |
Pvt |
2 |
2 |
N |
Act |
“…it is very easy to go and refer to a
guideline, so it was easy access to get a guideline, to Google a
guideline and then apply it… in my workload” |
P12 |
Pub |
3 |
1 |
D |
P-con |
“It sort of differs because of the
unexpected interruptions in my day to day work that suddenly comes from
above and then I have to adjust the program. There’re many unplanned
things coming to my table that wasn’t part of physio’s plan in for today
or for this week, and then you have to adjust” |
P13 |
Pvt |
1 |
1 |
D |
Con |
“I have seen people’s attitude where you
have, just mention the word guideline, they are like, oh, if it is big,
if it looks bulky and intense and long and forms and then immediately
there is a negative attitude towards it. I have had that before where I
have seen a guideline and I think, oh, there are so many papers to fill
in. So something concise, easy to use…” |
P14 |
Pvt |
3 |
1 |
D |
Main |
”…that is very much my job, writing
guidelines for clinical practice, so I think it is quite a good thing to
have it, but you know, one needs to be very careful that you do not
become too prescriptive…” |
P15 |
Pvt |
2 |
1 |
Y |
P-con |
”I will try not to sound too negative.
So guidelines are I think just generated by institutions in the first
world. The issue of guideline… they tend to become prescriptive
rather than descriptive…I think it is going to form part of the
armour because we are doing it to benchmark every now and then what the
current best practice is. At the moment they have become like sticks to
beat people with, so if you haven’t got to actually increase the range
by week two post-operative then all hell breaks loose…” |
P16 |
Ed |
3 |
2 |
N |
Act |
”…It plays a role in guiding the
appropriateness of the techniques that we use and hence once you are
using techniques that are tailor-made, you are definitely improving the
quality of care. Sometimes if they are structured, you are including
spending even lesser time than you used to. Secondly, another advantage
for the role that guidelines play, remember, you will have maybe a
maximum of an hour with a patient as a physio, so even that we are
talking who is the client that we are dealing with…” |
P17 |
Pvt |
2 |
1 |
D |
Prep |
…”I am not fantastically good at using
guidelines, so that is definitely something that I need to and have to
improve on… if you have guidelines as to the type of treatment that is
effective at different stages, you can also explain that to a
patient…” |
P18 |
Pub |
2 |
1 |
N |
Act |
”…physiotherapists have access to a
specific file for physiotherapy in itself and then with that the
physiotherapist whenever he is on the wards you can go through the
guidelines… You can run with the patient through it or just a
guideline as a quick reference, not having to run to a book or, I mean,
if you can use an APP that’s even better. But I mean, you don’t always
have the coverage for Wi-Fi… in that way we have guidelines
available to us… |
P19 |
Pvt |
1 |
2 |
Y |
Con |
“With the workload it can become a bit
difficult to follow the guidelines. Say I have to get the patient out in
a chair and you know he must be back in two hours then it’s a little
difficult to organise your day in such a manner that you … we travel
back and forth between different hospitals, so it is very very difficult
to schedule your day in order to fit everything in. Most of the days it
works, but it doesn’t always work” |
P20 |
Pvt |
2 |
2 |
Y |
P-con |
“…if it’s going to take a lot of
time it will be difficult, yes. Because we see a patient every half an
hour, and half an hour before and after work for admin, I think that
would be a bit difficult if we are not familiar with the guidelines. One
will have to first get used to them. It sounds like something that one
has to look for on a computer and I struggle to switch the computer
on” |
P21 |
Ed |
2 |
1 |
Y |
Main |
”…If you really use it well and you
follow those steps or those systematic statements in the order that it’s
been given you actually realise that it helps you to use your broad
knowledge but to come into the specifics and to treat each patient
differently…” |
P22 |
Ed |
2 |
1 |
N |
Act |
“…a practical way is just to engage
with, even if you don’t implement the whole guideline with every single
patient, but to try and think about what guideline with regards to set
patient, with regards to set guideline, whether there are multiple,
could I try and enforce on a daily basis in my patients or in my
practice, and stick to it and be good about that… And then just
encouraging others or making others aware of that…” |
P23 |
Ed |
2 |
1 |
D |
P-con |
“…you’re just trying to clear the
bench, and as soon as the patients have been seen and you’re shipping
them off to the next institution…because you’re dealing here with
a bench of 60 patients for the day…even workloads are so
different… there’s days I saw thirty-five patients in a day,
thirty-eight patients in a day and then there were days I saw twelve in
a day. So it would run differently on those different
days” |
P24 |
Pub |
1 |
1 |
D |
Main |
”…If you really use it well and you
follow those steps or those systematic statements in the order that it’s
been given you actually realise that it helps you to use your broad
knowledge but to come into the specifics and to treat each patient
differently…” |
P25 |
Ed |
2 |
2 |
D |
Prep |
“I think within our own profession it’s
possible. It also depends who you’re dealing with, but it’s trickier
when it now gets to kind of take this information to other professions
and saying look, let’s go maybe tell the doctors what we’re doing, or
the nurses… we aren’t really doing that. I think we have one
lecture that one of my staff teaches to the med students, just to kind
of tell them what physiotherapy is” |
P26 |
Pvt |
1 |
1 |
D |
Act |
“there’s always a hiccup in the beginning
and there’s always the usual little teething issues, but once we get the
hang of it, it just becomes part of the flow, and you don’t often think
twice about it once you’re used to it” |
P27 |
Pub |
1 |
2 |
D |
Con |
“moderately easy to start implementing
[CPGs], but it would also just be consistency… it’s easy to
implement something and to start doing it, but to carry on doing it I
feel is often a difficult thing, especially when you’re working in a
place like in public where you have people coming and going…
you’re not always the same team…” |
P28 |
Pub |
2 |
1 |
D |
Con |
“…If we are only two physios in
the hospital and we have a particular number of patients in the wards,
it means I might not be able to really go through whatever that I have
to go through because I’m rushing to see the next patient so that I can
cover everything…the shortage of staff would be a barrier… if
we are talking about out-patients we usually manage it… so that
everything can be accommodated in a day.” |
P29 |
Pub |
2 |
1 |
N |
Main |
”…I don’t want the outcomes of
treatment to be dependent on the physiotherapists themselves that are
seeing the patient…I want that patient to receive the same
quality of care than if that patient would have been seen by a
physiotherapist that specialises in that. A patient does not be at a
disadvantage just because of logistical reasons…” |
P30 |
Pub |
1 |
1 |
D |
P-con |
“If the guidelines can make my life
easier then it will be easy but if the guidelines will be a very lengthy
process then it will make it challenging. I think especially in our
setting, I work in a government institution and it’s the age-old thing
of being short-staffed but for example, we can’t see a patient twice a
day. I can’t guarantee that I will be able to see a patient twice a day
where in a private institution that is almost the norm… I think if
guidelines caused me to take more time with my patients, that will be
really difficult to implement because I still have twenty others also to
see” |
P31 |
Pub |
1 |
1 |
D |
Act |
“Technically it should make my clinical
load easier because if I have a guideline to work upon, it’s something
that should make seeing patients sort of easier…but sometimes I do
feel like time wise, I don’t know, maybe for example you don’t have time
to do ten repetitions times three sets for the patient and so you show
them all the exercise but you only do one set and then you show them how
to walk.” |
Key: ID=Participant identifier; Yrs=Years in practice; CPG-K=CPG
knowledge; SOC=Stage of change; Pub=Public; Pvt=Private; Ed=Education;
Y=Agree; N=Disagree; D=Do not know; P-con=Pre-contemplation;
Prep=Preparation; Con=Contemplation; Act=Action; Main=Maintenance |
Key: ID=Participant identifier; Yrs=Years in practice; CPG-K=CPG
knowledge; SOC=Stage of change; Pub=Public; Pvt=Private; Ed=Education;
Y=Agree; N=Disagree; D=Do not know; P-con=Pre-contemplation;
Prep=Preparation; Con=Contemplation; Act=Action; Main=Maintenance |
Key: ID=Participant identifier; Yrs=Years in practice; CPG-K=CPG
knowledge; SOC=Stage of change; Pub=Public; Pvt=Private; Ed=Education;
Y=Agree; N=Disagree; D=Do not know; P-con=Pre-contemplation;
Prep=Preparation; Con=Contemplation; Act=Action; Main=Maintenance |
Key: ID=Participant identifier; Yrs=Years in practice; CPG-K=CPG
knowledge; SOC=Stage of change; Pub=Public; Pvt=Private; Ed=Education;
Y=Agree; N=Disagree; D=Do not know; P-con=Pre-contemplation;
Prep=Preparation; Con=Contemplation; Act=Action; Main=Maintenance |
Key: ID=Participant identifier; Yrs=Years in practice; CPG-K=CPG
knowledge; SOC=Stage of change; Pub=Public; Pvt=Private; Ed=Education;
Y=Agree; N=Disagree; D=Do not know; P-con=Pre-contemplation;
Prep=Preparation; Con=Contemplation; Act=Action; Main=Maintenance |
Key: ID=Participant identifier; Yrs=Years in practice; CPG-K=CPG
knowledge; SOC=Stage of change; Pub=Public; Pvt=Private; Ed=Education;
Y=Agree; N=Disagree; D=Do not know; P-con=Pre-contemplation;
Prep=Preparation; Con=Contemplation; Act=Action; Main=Maintenance |
Key: ID=Participant identifier; Yrs=Years in practice; CPG-K=CPG
knowledge; SOC=Stage of change; Pub=Public; Pvt=Private; Ed=Education;
Y=Agree; N=Disagree; D=Do not know; P-con=Pre-contemplation;
Prep=Preparation; Con=Contemplation; Act=Action;
Main=Maintenance |
Yrs in practice: 0-10=1; 11-20=2; 21+=3. CPG knowledge: 1=Understand
concept of CPGs; 2=Does not understand concept of CPGs |
Yrs in
practice: 0-10=1; 11-20=2; 21+=3. CPG knowledge: 1=Understand concept of
CPGs; 2=Does not understand concept of CPGs |
Yrs in practice: 0-10=1;
11-20=2; 21+=3. CPG knowledge: 1=Understand concept of CPGs; 2=Does not
understand concept of CPGs |
Yrs in practice: 0-10=1; 11-20=2; 21+=3.
CPG knowledge: 1=Understand concept of CPGs; 2=Does not understand
concept of CPGs |
Yrs in practice: 0-10=1; 11-20=2; 21+=3. CPG
knowledge: 1=Understand concept of CPGs; 2=Does not understand concept
of CPGs |
Yrs in practice: 0-10=1; 11-20=2; 21+=3. CPG knowledge:
1=Understand concept of CPGs; 2=Does not understand concept of CPGs |
Yrs in practice: 0-10=1; 11-20=2; 21+=3. CPG knowledge: 1=Understand
concept of CPGs; 2=Does not understand concept of CPGs |