Physiotherapists’ perspectives on factors affecting the scope of in-home palliative care treatments: a qualitative study

Background: Physiotherapy has demonstrated significant benefits in enhancing quality of life and managing symptoms of people in need of palliative care (PC). Despite these benefits, palliative physiotherapy is infrequently integrated into community-based care, where most PC services are delivered. The limited prevalence of these treatments highlights the need to explore the factors influencing their delivery in home settings. Objectives: This study‎ aimed to elucidate the factors that influence the scope of occasional in-home palliative physiotherapists’ interventions as perceived by the physiotherapists who provide these treatments. Methods: A qualitative study was conducted, involving 15 physiotherapists (nine women and six men), all employed by a Health Maintenance Organization (HMO), who typically work in community-based clinics but occasionally provide palliative physiotherapy treatments outside of their regular working hours. Data were collected via in-depth, semi-structured interviews, using an interview guide and analyzed using reflective thematic analysis. Result: Two main themes emerged: (1) External factors influencing the scope of palliative physiotherapy treatments. These include patients’ characteristics and their disposition toward palliative physiotherapy treatments, family dynamics amongst each other and with the physiotherapists, and interactions of the physiotherapists with the palliative multidisciplinary team; (2) Physiotherapists‎’‎ inclination to provide PC treatments. This theme encompasses the physiotherapists’ knowledge, role perception, emotional experiences, and coping strategies during the provision of PC. Conclusion: External and personal factors shape the scope of in-home PC treatments. Improving communication and addressing emotional challenges and coping strategies could enhance care delivery.