CLINICIANS’ PERCEPTIONS OF MANUAL HANDLING POLICIES IN STROKE REHABILITATION: A QUALITATIVE FOCUS GROUP STUDY

Abstract

Objectives The professional literature guides manual handling in numerous health care settings. The effects of these guidelines on stroke rehabilitation and the clinical communication of health care professionals are unknown. This paper aims to investigate the perspectives of nurses and physiotherapists on handling guidelines in their professions to identify conflicts in opinions to provide optimum care to people with stroke. Design A qualitative focus group study. Methods Three focus groups were conducted. The participants were physiotherapists or nurses with 1 year of stroke care experience. The data were thematically analysed. Results Nineteen participants (12 physiotherapists and 7 nurses) were interviewed. The data analysis revealed 3 themes. First, “The application of handling in stroke rehabilitation” includes clinical reasoning and real-world handling practices. The second theme, “Physical Effects on Therapists,” examines the long-term effects of manual handling on therapists, including work-related musculoskeletal disorders. The final theme, “Conflicts among health care professionals,” investigates stroke rehabilitation equipment conflicts between nurses and physiotherapists. Conclusion The study concludes that stroke transfer guidelines in the specialised literature may impact health care professionals’ perspectives. Conflicts among health care professionals can impair teamwork. Thus, health care professionals should work together as stroke rehabilitation teams to develop unified transfer guidelines that aid rehabilitation and avoid work-related musculoskeletal disorders. LAY ABSTRACT Transfer training is a significant part of the care that physiotherapists and nursing professionals provide in stroke rehabilitation. In the context of transferring individuals with strokes, therapists regularly find themselves assuming various physically demanding positions, such as bending and twisting, to provide necessary assistance to the patient. As a consequence of the repetitive and physically demanding nature of this field of rehabilitation, work-related musculoskeletal disorders are common. The professional literature advises professionals to avoid work-related musculoskeletal disorders through manual handling. This study compared nurses’ and physiotherapists’ opinions on stroke rehabilitation handling guidelines, the “no-lift policy,” and equipment utilisation. Three focus groups were held with 12 physiotherapists and 7 nurses. The findings showed high levels of back pain and physiotherapist-nurse conflict. These findings emphasise the need to unify handling guidelines from different professional literature sources to reduce work-related musculoskeletal disorders and resolve health care professionals’ conflicts caused by different rules and guidelines in their professional literature.