Addressing Physical Activity among Adults 50+: An Ethnographic Study of Physical Therapists

1) Gain insight into PA prescription by United States-based physical therapists treating patients 50 years and older, and 2) Explore the contextual factors that impact PA prescription. We integrated ethnographic study data, including a questionnaire, observations, and semi-structured interviews. Our nine participants with 24.7 years (SD= 11.6) of clinical experience completed frequent PA assessments, but PA prescription was inconsistent. The following themes helped explain the participants’ clinical decisions: 1) treatment prioritization; 2) physical therapists’ intentions of addressing PA; and 3) contextual factors that impact treatment and treatment prioritization (e.g., experience, beliefs, concerns related to PA prescription, and work environment). Most participants did not address PA among adults 50 years and older. Due to the importance of performing regular PA, it is vital for physical therapists to reflect on their PA prescription. Organizations and health service researchers need to implement strategies that address the PA prescription barriers.

1) 深入洞察美国物理治疗师为50岁及以上患者开具体力活动（PA, Physical Activity）处方的实践现状；2) 探究影响体力活动处方制定的各类情境因素。本研究整合了民族志研究数据，涵盖问卷调研、现场观察与半结构化访谈。共有9名参与者，其临床从业经验均值为24.7年（标准差SD=11.6）；尽管他们会频繁开展体力活动评估，但在体力活动处方的开具上存在明显不一致性。可解释参与者临床决策的核心主题包括：1）治疗优先级的设定；2）物理治疗师处理体力活动相关问题的主观意向；3）影响治疗决策与治疗优先级的情境因素（例如临床经验、个人信念、与体力活动处方相关的顾虑，以及工作环境等）。绝大多数参与者未针对50岁及以上成年人开展体力活动相关指导。鉴于规律体力活动对健康的重要意义，物理治疗师有必要对自身的体力活动处方制定行为进行反思。医疗机构与卫生服务研究者需出台针对性策略，以破解体力活动处方制定过程中的各类障碍。