{"title":"Perspectives on adherence to prescribed home exercises after polytrauma: A qualitative study.","authors":"Keamogetswe Monaiwa, Mariatha Yazbek, Nontembiso Magida","doi":"10.4102/sajp.v81i1.2163","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Polytrauma can be life altering, requiring a holistic approach to reach the highest functional level. Physiotherapists prescribe home exercise programmes (HEPs) to prevent complications associated with immobility. Adherence to HEPs is crucial, yet factors influencing non-adherence remain underexplored.</p><p><strong>Objectives: </strong>Our study explored patients with polytrauma perspectives on adherence to prescribed HEPs.</p><p><strong>Method: </strong>A qualitative exploratory, descriptive design was used to recruit participants purposively from a rehabilitation unit in Tshwane district, South Africa. Participants diagnosed with polytrauma, aged 18 years or older, and prescribed a HEP were included, while those with cognitive impairments or language barriers were excluded. Consent was obtained while hospitalised, and participants were contacted 3 months post-discharge for telephonic semistructured interviews lasting 30-45 min. Ethical clearance (reference number: 595/2022) and institutional permission were granted. Interviews were audio-recorded and conducted until data were saturated. Data were verbatim transcribed and analysed thematically to identify key themes and sub-themes.</p><p><strong>Results: </strong>Thirteen participants (8 male and 5 female participants) with a mean age of 43.77 (standard deviation = 10.45) were interviewed. The four major themes were physical, psycho-cognitive, social and environmental factors. Adherence barriers were more significant than facilitators. The most frequently reported facilitator was family support, whereas the most commonly reported barrier was pain.</p><p><strong>Conclusion: </strong>Polytrauma patients identified more barriers than facilitators affecting HEP adherence. Pain significantly hindered adherence, while family support was a key enabler.</p><p><strong>Clinical implication: </strong>Physiotherapists should work collaboratively with patients to develop inclusive HEPs that consider their demographic, social, psychological, physical and environmental context.</p>","PeriodicalId":44180,"journal":{"name":"South African Journal of Physiotherapy","volume":"81 1","pages":"2163"},"PeriodicalIF":1.0000,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224004/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"South African Journal of Physiotherapy","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4102/sajp.v81i1.2163","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"REHABILITATION","Score":null,"Total":0}
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Abstract
Background: Polytrauma can be life altering, requiring a holistic approach to reach the highest functional level. Physiotherapists prescribe home exercise programmes (HEPs) to prevent complications associated with immobility. Adherence to HEPs is crucial, yet factors influencing non-adherence remain underexplored.
Objectives: Our study explored patients with polytrauma perspectives on adherence to prescribed HEPs.
Method: A qualitative exploratory, descriptive design was used to recruit participants purposively from a rehabilitation unit in Tshwane district, South Africa. Participants diagnosed with polytrauma, aged 18 years or older, and prescribed a HEP were included, while those with cognitive impairments or language barriers were excluded. Consent was obtained while hospitalised, and participants were contacted 3 months post-discharge for telephonic semistructured interviews lasting 30-45 min. Ethical clearance (reference number: 595/2022) and institutional permission were granted. Interviews were audio-recorded and conducted until data were saturated. Data were verbatim transcribed and analysed thematically to identify key themes and sub-themes.
Results: Thirteen participants (8 male and 5 female participants) with a mean age of 43.77 (standard deviation = 10.45) were interviewed. The four major themes were physical, psycho-cognitive, social and environmental factors. Adherence barriers were more significant than facilitators. The most frequently reported facilitator was family support, whereas the most commonly reported barrier was pain.
Conclusion: Polytrauma patients identified more barriers than facilitators affecting HEP adherence. Pain significantly hindered adherence, while family support was a key enabler.
Clinical implication: Physiotherapists should work collaboratively with patients to develop inclusive HEPs that consider their demographic, social, psychological, physical and environmental context.
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