Theme 3: demands on the patient
| Factor | Description | Patients accounts | Healthcare professionals accounts |
| Care requirements | The requirements of care | It depends what you're asking them to—if it was—it depends. If it’s something simple then, yes, that’s a good idea. If it’s something a bit more complicated they actually have to come and see it because it’s more of a hands-on type of thing (P8) I suppose it’s not so much the conversations but the physical things that you might have to do. It would be very difficult for them to work out—if you're talking physiotherapy—just how your joints were working. They couldn't really see what your back was doing or how your arm was working or whatever, and you can't—they need to feel. Physiotherapy’s quite a hands on the body sort of thing (P4) It’s ridiculous in the sense that appointments have almost become a full-time job for me. I'm really grateful, I've got a lovely team of people that know me very well and look after me (P10) | How many exercises can they realistically fit in their day? I'd rather they did one or two really well then five or six badly (C11) I guess if they've had no restrictions really at all, then to completely have those restrictions—and it can be quite debilitating because they're so used to being independent and not having to really rely on others (C4) We do often use our hands for some assessment in terms of feeling for muscle-activated patterns or guarding (C15) We do lay on our hands. It might well be around showing someone that they've become really hypersensitive. Touching them on an area of skin that is not at all uncomfortable and saying what does that feel like, does it feel like I'm poking, whatever, and then putting your hand on their back or something and then say how does that feel? (C10) |
| Social demands | The competing life demands that can interfere with healthcare. | I think, because I'm not looking after my mum, my mum has gone into a care home now. At the moment I haven't a job. I'm not working. I'm at home, I'm just doing things at home. I still go to the care home and sort things out for mum and appointments and that (P2) | I think for some people things are muddling along and I probably should work on my routine, but I've got my kids, I've got my work—this takes priority and that’s I think my role is trying to tease that out a bit more. So, what is your priority right now? (C12) Maybe this is where the overwhelmingness comes in because if you are not doing any of things you suddenly feel like you have to change your entire life to be able to manage if some of what we have said isn’t said carefully (PC1) |
| Consequences of choice | The impact of choice | For me, it’s the equipment. I only live in a small—and it is small, isn't it—a small two-bedroom house. I would have nowhere to store the equipment… there’s no option out there to rent equipment (P19) Some of the stuff he doesn't need to touch me for, like when he’s watching me do a squat. Are my knees going the right way? Yeah. He can do that over a FaceTime. That’s absolutely fine. But as you say, he needs to—if he wants to check my strength physically, then yeah, I need to be here. It only limits that (P14) | You might subconsciously use that (travel time) in a beneficial way… If you are straight in on a computer screen maybe there is some prep time that is not build in to the process as easily and you have to be mindful of preparing yourself beforehand (PC1) If you think about the patient that is actually sent into a flare-up from the journey that they've made…(C8) So often if they want to try and demonstrate exercises, a common feedback is the fact that their bed’s too hard or too soft and it doesn't work, and the plinths are easier to do it (C1) |