Physiotherapists' experiences of respiratory compromise in patients with Parkinson's disease: A qualitative study

Background/Aims: To explore the experiences and perceptions of physiotherapists involved in the care of people with Parkinson's disease and respiratory compromise. Methods: This exploratory qualitative study recruited four physiotherapists who participated in a focus group and completed reflective diaries over a 3-month period, Experiences were explored using Interpretative Phenomenological Analysis. Findings: The study highlights three key themes: application of professional knowledge, application of clinical decision making and challenges to application of care. Conclusions: The results demonstrate sensitive awareness in caring for a dependent and vulnerable population whose key motor signs, compounded by ageing are perceived as influencing the presentation of respiratory compromise. There are descriptions of a reactive response to illness, alongside reflections on the challenges faced when asserting autonomy and recognising where the role of physiotherapy fits within the multidisciplinary team. Sputum clearance is perceived as being a key aspect of this role, although there is uncertainty with regard to the effectiveness and appropriateness of treatment options. Multiple perceived challenges to care provision are highlighted, with key concerns surrounding clinician and patient knowledge levels, maintenance of patient mobility, person-centred care and clarity in the direction of care.