The clinical experiences of Nigerian physiotherapists in managing environmental and socioeconomic determinants of mobility for older adults

ABSTRACT

Study Aim: To describe how physiotherapists in northern Nigeria managed the environmental and socioeconomic determinants of mobility for older adults.

Methods: We adopted a qualitative description approach, purposely selected and conducted telephone interviews with 20 physiotherapists from Abuja [the Federal Capital Territory], four of the six states in North-central, and one state in the North-west regions of Nigeria. Data were analyzed using qualitative content and constant comparative analyses.

Result: The physiotherapists had between 5 and 11 years practice experience in managing older adults with mobility limitations. Three iterative stages of identification, intervention, and documentation emerged as clinical experiences of Nigerian physiotherapists in managing environmental and socioeconomic determinants of mobility for older adults. Identification stages included determining older adults with mobility limitation through patients’/physiotherapists’ reports and identifying the environmental (e.g. staircase location, floor types, furniture, and the urban built environment) and socioeconomic (e.g. education, income, and occupation) factors. The clinical decision of the “best” individualized approach to intervention, providing reassurance and education during and after the intervention were sub-stages for the intervention stage. There is a potential gap in the documentation process of these stages as most of the physiotherapists (n = 15; 75%) reported not doing so.

Conclusion: This study suggested three iterative stages of identification, intervention, and documentation of the environmental and socioeconomic determinants of mobility for older adults. While there was a potential gap in regard to documentation of these stages in patients' case notes, physiotherapists especially in North-central Nigeria believed that co-developing a pragmatic set of clinical questions focusing on these determinants of mobility could encourage physiotherapists to explicitly document them. As the approach used in our research is purely descriptive, a grounded theory approach would potentially provide more detailed sub-stages that could be a more effective guide for physiotherapists to use during clinical practice.

KEYWORDS:

• Environment
• socioeconomic status
• mobility
• older adults
• physiotherapy

Acknowledgments

The authors want to acknowledge Dr. Kathryn Wicks for her supervisory role in this project at the University of Southampton. The authors also thank all the members of Emerging Researchers and Professionals in Aging-African Network (ERPAAN) for their contribution throughout this project, and the Commonwealth Scholarship Commission, as this project is a product of an MSc Scholarship.

Conflict of Interest

None to declare.