Where and how does physical therapy fit? Integrating physical therapy into interprofessional HIV care

Abstract

Purpose: To investigate the role of physical therapy in HIV care from the perspective of people living with HIV and health care professionals with expertise in HIV care.

Methods: We conducted a qualitative descriptive study using semistructured interviews (with health care professionals) and focus groups (with people living with HIV). We purposively sampled health care professionals and recruited people living with HIV in collaboration with an HIV-specialty hospital. We asked participants about their knowledge of and experiences with physical therapy, and perceptions of the physical therapy role in interprofessional HIV care. We analyzed data using content analytical techniques.

Results: Thirteen people living with HIV and 12 health care professionals conceptualized physical therapy as positively influencing independence and social participation, and as a valuable ally in interprofessional collaboration. The Framework of Physical Therapy Role in HIV Care consists of two components: (1) multidimensional and client-centered roles of physical therapy addressing physical, psychological and social health domains; and (2) contextual factors important to consider for the role of physical therapy: aging, episodic nature of HIV, multimorbidity, competing priorities, continuity of care, stigma, resource security and social isolation. The interaction between contextual factors and health domains can influence the role of physical therapy.

Conclusion: The role of physical therapy in HIV is multidimensional and client-centered. This Framework can be used by rehabilitation professionals working with people living with HIV.

Implications for Rehabilitation

• Participants living with HIV in this study experienced physical therapy as a means of addressing rehabilitation goals that positively influenced physical health and social participation.

• The role of physical therapy in HIV care is multidimensional and client-centered and can address health challenges in physical, social and psychological health domains.

• The presence and interaction of contextual factors including aging, episodic nature of HIV, multimorbidity, competing priorities, continuity of care, stigma, resource security and social isolation are important for clinicians to consider in order to optimize healthcare for people living with HIV.

• The Framework describing the role of physical therapy in HIV care can be used by rehabilitation professionals to help inform their approach for providing client-centered HIV care.

Keywords:

• Physical therapy
• HIV/AIDS
• disability
• rehabilitation
• aging
• client-centered care

Acknowledgements

We thank the people living with HIV and health care professionals for their participation in this study. We acknowledge Sarah Munce, Kenneth King, as well as Giovanni Iacono and other Casey House staff for their support in protocol development, recruitment and data collection. We thank Rob Page for his assistance with Figure 1.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Kelly K. O’Brien was supported by a New Investigator Award from the Canadian Institutes of Health Research (CIHR) and an Early Researcher Award with the Ontario Ministry of Research and Innovation. This research was completed in partial fulfillment of the requirements for an MScPT degree at the University of Toronto. This study was funded by the Ontario Physiotherapy Association (OPA) Central Toronto District of Toronto MScPT Research Grant Award.