Evaluating the current practice of therapeutic positioning in neurological rehabilitation: a qualitative interview study

Therapeutic positioning is believed to enable the achievement of a good postural alignment, optimise rehabilitation and prevent the complications of immobility. It is considered important in the management of people with physical neurological impairments, but achieving a favourable position in a bed can be challenging. There is little evidence to inform present practice. Therefore, this study explored staff views and experiences of bed positioning practice on a regional neurological rehabilitation unit. Face-to-face, semi-structured interviews were completed with a purposive sample of nurses, physiotherapists and occupational therapists working on a neurological rehabilitation unit. The interviews were audio recorded, transcribed and analysed using inductive thematic analysis. A total of 12 participants completed an interview and six themes were identified relating to positioning practice. An interaction of four of these themes (patient needs, staff role, communication and knowledge) influenced a fifth theme of staff experiences. The sixth theme of practical positioning resources identified a pattern of resource use within current practice. Positioning was recognised as integral to rehabilitation, and staff experiences were influenced by the interaction of a range of factors. The participants’ views and experiences around practical positioning resources provide a valuable new insight into positioning practice. Further research is needed to evaluate these resources.