Barriers and facilitators of integrating physiotherapy into primary health care settings: A systematic scoping review of qualitative research.

Shabnam ShahAli, Saeed Shahabi, Manal Etemadi, Maryam Hedayati, Barth Cornelia Anne, Parviz Mojgani, Masoud Behzadifar, Kamran Bagheri Lankarani
Author Information
  1. Shabnam ShahAli: Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
  2. Saeed Shahabi: Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
  3. Manal Etemadi: The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, UK.
  4. Maryam Hedayati: Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
  5. Barth Cornelia Anne: School of Public Health, Physiotherapy and Sports Science, University College Dublin (UCD), Dublin, Ireland.
  6. Parviz Mojgani: Iran-Helal Institute of Applied Science and Technology, Tehran, Iran.
  7. Masoud Behzadifar: Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran.
  8. Kamran Bagheri Lankarani: Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.

Abstract

Purpose: This scoping review investigated the barriers and facilitators to integrating physiotherapy into primary health care (PHC).
Materials and methods: PubMed, Scopus, Web of Science, Embase, ProQuest, and REHABDATA were searched. Two independent reviewers were involved in screening, selecting, and extracting data. Data were synthesized using thematic analysis.
Results: Of the 483 screened documents, 44 qualitative studies, primarily from high-income countries, were included. All of the studies had good methodological quality. Barriers and facilitators of integrating physiotherapy into PHC were extracted within the WHO six building blocks framework. In total, 41 items were identified as barriers to the integration process. The studies included 49 recommendations to facilitate integrating physiotherapy services into PHC.
Conclusion: Integrating physiotherapy services into PHC faces many barriers. The most commonly suggested potential barriers are poor knowledge of physicians about physiotherapy, ineffective teamwork, physiotherapists' time constraints/workload, a lack of clarity over the role and knowledge of physiotherapists, unawareness of physiotherapy users about these services, and lack of intra- and inter-professional collaborations. The most commonly suggested recommendations to facilitate the integration process include: Clarifying the role of involved professionals, strengthening teamwork, improving intra- and inter-professional collaborations, and providing comprehensive training programs for physiotherapists.

Keywords

References

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