Aim: The main goal of the study is to explore which factors patients with stroke consider the most important during their rehabilitation process. This allows to investigate whether diverse factors are specific in the field of neurological physiotherapy over than those already known in the musculoskeletal field, to determine whether and to what extent the outcome of physiotherapy can be influenced by contextual factors, even in the context of neurological physiotherapy. Materials and Methods: A research was conducted in five different databases (Cochrane Library, EBSCO - CINAHL, PUBMED, SCOPUS, and Web of Science). The research string was developed considering both strings from previous researches in the field and the reference list of other meta-analyses. The study population included adults affected by stroke who had been exposed to contextual factors. Only articles written in Italian and English with abstracts available were included in the review process, with no limitations on the publication year. Article selection occurred in two stages: an initial evaluation based on title and abstract, followed by full-text analysis. Additionally, a methodological assessment of the quality of the included studies was conducted using the tool provided by the Critical Appraisal Skills Programme (CASP). Results: The meta-synthesis considered a total of 24 qualitative articles. The topics covered in the various articles were diverse, with the majority of them focusing on the therapist-patient relationship, in line with the most explored domains in the musculoskeletal field. Other specific topics concerning the patient-family relationship and the relationship with people affected by the same condition emerged. The risk of bias assessment revealed that the methodological quality of the studies was generally good: twenty out of the twenty-four studies were considered high quality, while four were classified as moderate quality. Conclusions: In light of the results obtained, it is evident that contextual factors play a crucial role in the management of stroke patients. In addition to the factors highlighted in the musculoskeletal field, two new subcategories were identified: the relationship with caregivers and the relationship with people affected by the same condition. Therefore, physiotherapists operating in the neurological field are encouraged to consider the importance and influence of contextual factors to improve the quality of clinical decisions and the outcomes of administered therapies. This research provides valuable insights for creating a new search string using the SPIDER methodology, which should be launched in various databases to conduct a more specific search for qualitative studies.
Obiettivo: L'obiettivo della meta-sintesi è esplorare le percezioni dei pazienti colpiti da ictus al fine di identificare i fattori che ritengono più importanti durante il loro processo di riabilitazione. Questo permette di confrontare tali fattori con quelli precedentemente studiati nel campo muscolo-scheletrico, per determinare se e in che misura il risultato della fisioterapia può essere influenzato dall'interazione con i fattori contestuali, anche nell’ambito neurologico. Materiali e metodi: È stata eseguita una ricerca in cinque diverse banche dati (Cochrane Library, EBSCO - CINAHL, PUBMED, SCOPUS e Web of Science). Lo sviluppo della stringa di ricerca ha tenuto in considerazione sia stringhe sviluppate per precedenti ricerche, che le bibliografie di meta-sintesi. La popolazione oggetto di studio comprendeva adulti colpiti da ictus in cui fossero reperibili i fattori di contesto a cui erano stati esposti. Solo gli articoli scritti in italiano ed inglese con disponibilità di abstract sono stati inclusi nel processo di revisione, senza limitazioni di anno di pubblicazione. La selezione degli articoli è stata effettuata in due fasi: una prima fase di valutazione basata su titolo ed abstract, seguita dall’analisi dei full text. Inoltre, è stata condotta una valutazione metodologica della qualità degli studi inclusi utilizzando lo strumento fornito dal Critical Appraisal Skills Programme (CASP). Risultati: La meta-sintesi ha preso in considerazione un totale di ventiquattro articoli di natura qualitativa. Diversi argomenti sono stati trattati all’interno degli articoli, con la maggior parte di essi concentrati sulla relazione tra il terapista e il paziente, in linea con i domini più esplorati anche in ambito muscolo-scheletrico. Altri argomenti emersi riguardavano la relazione paziente-familiare e con le persone colpite dalla stessa patologia. La valutazione del rischio di bias ha rivelato che la qualità metodologica degli studi era generalmente buona: venti dei ventiquattro studi sono stati considerati di alta qualità, mentre quattro sono stati classificati come di moderata qualità. Conclusioni: Alla luce dei risultati ottenuti, è emerso come i fattori di contesto svolgano un ruolo cruciale nella gestione dei pazienti affetti da ictus. Oltre ai fattori già noti in ambito muscolo-scheletrico sono state evidenziate due nuove sottocategorie: la relazione con i caregiver e la relazione con le persone colpite dalla stessa patologia. Si incoraggiano, quindi, i fisioterapisti che operano nel campo neurologico a tenere in considerazione l'importanza e l'influenza dei fattori di contesto al fine di migliorare la qualità delle decisioni cliniche e l'esito delle terapie somministrate. Questa ricerca fornisce spunti preziosi per andare a creare una nuova stringa di ricerca con la metodologia SPIDER che dovrà essere poi lanciata nei vari database, in modo da vere una ricerca maggiormente specifica riguardo agli studi qualitativi.
RUOLO DEI FATTORI DI CONTESTO NELLA RIABILITAZIONE DOPO ICTUS: METANALISI DI STUDI QUALITATIVI
CARDINALE, CHIARA
2022/2023
Abstract
Aim: The main goal of the study is to explore which factors patients with stroke consider the most important during their rehabilitation process. This allows to investigate whether diverse factors are specific in the field of neurological physiotherapy over than those already known in the musculoskeletal field, to determine whether and to what extent the outcome of physiotherapy can be influenced by contextual factors, even in the context of neurological physiotherapy. Materials and Methods: A research was conducted in five different databases (Cochrane Library, EBSCO - CINAHL, PUBMED, SCOPUS, and Web of Science). The research string was developed considering both strings from previous researches in the field and the reference list of other meta-analyses. The study population included adults affected by stroke who had been exposed to contextual factors. Only articles written in Italian and English with abstracts available were included in the review process, with no limitations on the publication year. Article selection occurred in two stages: an initial evaluation based on title and abstract, followed by full-text analysis. Additionally, a methodological assessment of the quality of the included studies was conducted using the tool provided by the Critical Appraisal Skills Programme (CASP). Results: The meta-synthesis considered a total of 24 qualitative articles. The topics covered in the various articles were diverse, with the majority of them focusing on the therapist-patient relationship, in line with the most explored domains in the musculoskeletal field. Other specific topics concerning the patient-family relationship and the relationship with people affected by the same condition emerged. The risk of bias assessment revealed that the methodological quality of the studies was generally good: twenty out of the twenty-four studies were considered high quality, while four were classified as moderate quality. Conclusions: In light of the results obtained, it is evident that contextual factors play a crucial role in the management of stroke patients. In addition to the factors highlighted in the musculoskeletal field, two new subcategories were identified: the relationship with caregivers and the relationship with people affected by the same condition. Therefore, physiotherapists operating in the neurological field are encouraged to consider the importance and influence of contextual factors to improve the quality of clinical decisions and the outcomes of administered therapies. This research provides valuable insights for creating a new search string using the SPIDER methodology, which should be launched in various databases to conduct a more specific search for qualitative studies.File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12608/56862