Communicating information and professional knowledge in acquired brain injury rehabilitation trajectories – a qualitative study of physiotherapy practice

Abstract

Purpose: The communication of information and professional knowledge is paramount during patient transitions, and conveying practice knowledge is an important part of the health professional’s role. Physiotherapy interventions in both specialist and primary health care are often necessary to aid persons in rehabilitation following an acquired brain injury (ABI). The aim of this study was to investigate how physiotherapists experience the way patient information is communicated across health care levels in ABI rehabilitation.

Methods: We performed interviews with a total of 19 physiotherapists related to the rehabilitation trajectories of 10 people with acquired brain injuries. We performed a systematic text condensation analysis informed by constructionist and interactionist perspectives and theories of learning.

Results: The physiotherapists in this study considered the patients to be complex and resource intensive. Written information upon hospital discharge was necessary but not sufficient, and they emphasized the need for verbal communication and closer collaboration across health care levels and clinical settings.

Conclusions: The findings in this study indicate the need to improve routines for the communication of information and to clarify issues related to economy and responsibilities. Collaboration across health care levels require reciprocal understanding of the contextual differences in rehabilitation trajectories.

Implications for rehabilitation

• The discharge process is an important arena for continuous development of collaborative practices in the neurological rehabilitation context.

• Rehabilitation trajectories should be customized for the specific patient in a manner that is closely connected to contextual limitations and affordances.

• Communication between health care professionals in the transitional phase of rehabilitation trajectories is important to identify altered prerequisites for providing rehabilitation services in the primary care context.

Keywords:

• Brain injury
• rehabilitation
• physiotherapy
• quality of care
• professional education
• social constructionism

Acknowledgements

We thank all the subjects, hospitals and municipalities for participating in this study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Norwegian Fund for Post-Graduate Training in Physiotherapy; and the Centre for Care Research, North Norway