Characterization of the barriers to accessing/obtaining results in physiotherapy during the pandemic
| Barriers to accessing/obtaining results in physiotherapy | x ± SD | % answers scoring 5 |
|---|---|---|
| Risk of exposure of professionals (lack of PPE; PPE not certified) | 2.13 ± 1.80 | 8.50 |
| Insufficient or inappropriate referral mechanisms | 3.17 ± 1.76 | 25.4 |
| Interruption of rehabilitation processes / restricted access to specialized monitoring in a prophylactic isolation context; | 3.94 ± 1.47 | 49.2 |
| disruption in the routine of the person with dementia and caregiver | 4.06 ± 1.32 | 49.2 |
| Difficulty in accessing and using computer systems for sessions (in real time; for autonomous work) of telephysiotherapy (digital literacy) | 3.40 ± 1.47 | 27.1 |
| Reduced mental health literacy | 3.28 ± 1.64 | 28.8 |
| Breakdown in social interaction (isolation, distancing from your social networks | 4.13 ± 1.37 | 57.6 |
| Limitation of rehabilitation material (limitation of material resources in home-based physiotherapy) | 2.38 ± 1.86 | 13.6 |
| Personal protective equipment (PPE) and physical distancing hinder communication and relationship with the person with dementia, which can lead to behavioral changes | 4.02 ± 1.28 | 47.5 |
| Difficulty in referrals to other professionals (in periods of exacerbation; new symptoms) | 3.21 ± 1.63 | 22.0 |
| Polymedication / self-medication | 2.21 ± 1.77 | 11.9 |
| Adherence to treatment in its new formats (e.g., resistance to assume new responsibilities in physiotherapy treatment) | 3.12 ± 1.52 | 1.9 |
| Fears of the patient and family associated with the pandemic | 3.77 ± 1.52 | 42.4 |
| Low motivation of the family-user dyad | 3.02 ± 1.59 | 15.3 |
| Time constraints of professionals (time spent on disinfection; PPE accommodation; traveling time) | 2.88 ± 1.79 | 18.6 |
| Economic/financial constraint | 2.77 ± 1.94 | 23.7 |
| Lack of encouragement to find out physiotherapist services (poor interprofessional network) | 2.46 ± 1.85 | 11.9 |
| Distrust and concerns regarding confidentiality on the part of the caregiver | 1.52 ± 1.78 | 6.80 |
| Caregivers’ time constraints | 2.17 ± 1.76 | 8.50 |
Characteristics of the people with dementia/cognitive decline treated by the participants
| Characteristics of people with dementia/cognitive decline doing physiotherapy | Percentage % |
|---|---|
| Age (yrs) | |
| < 65 yrs | 16.9 |
| 65–85 yrs | 67.8 |
| > 85 yrs | 15.3 |
| Cognitive decline | |
| Yes | 88.1 |
| No | 11.9 |
| Dementia | |
| Yes | 83.1 |
| No | 16.9 |
Description of professional and training experience of the surveyed physiotherapists
| Workplace | Percentage % |
|---|---|
| People’s Home | 18.6 |
| Hospital | 6.8 |
| Long-term Care Unit /community | 25.4 |
| Clinic/Office | 11.9 |
| Social and solidarity private institution | 33.9 |
| Other | 3.4 |
| Professional Experience (yrs) | |
| Up to 5 yrs | 42.4 |
| 5–10 yrs | 32.2 |
| >10 yrs | 25.4 |
| Professional experience in multidisciplinary team | |
| Yes | 27.1 |
| No | 72.9 |
| Specific training in this field | |
| Experience as a trainer | |
| Yes | 86.4 |
| No | 13.6 |
| Frequency of seminars/congresses | |
| None | 16.9 |
| Up to 10 hours | 28.8 |
| 10–35 hours | 30.5 |
| >35 hours | 23.7 |
| Webinars | |
| None | 47.5 |
| Up to 10 hours | 35.6 |
| 10–35 hours | 11.9 |
| >35 hours | 5.1 |
| Postgraduate | |
| Yes | 16.9 |
| No | 83.1 |
| Master’s degree | |
| Yes | 6.80 |
| No | 93.2 |
| Doctoral degree | |
| Yes | 0.00 |
| No | 100.00 |
Characterization of the impact of the COVID-19 pandemic on physiotherapy in people with cognitive impairment/dementia
| Impacts of the pandemic on the rehabilitation process | % answers scoring 5 | x ± SD |
|---|---|---|
| Withdrawal from services | 27.1 | 3.38 ± 1.65 |
| Worsening of the clinical status (including comorbidities) of the person with dementia | 52.5 | 4.23 ± 1.12 |
| Increased risk of falling | 50.8 | 4.02 ± 1.30 |
| Intervention plan to carry out with the help of the caregiver | 15.3 | 3.10 ± 1.43 |
| Changing the treatment plan | 20.3 | 3.33 ± 1.39 |
| Referral to integrated convalescent care units (caregiver respite) | 22.0 | 2.52 ± 2.06 |
| Decreased frequency of interventions | 47.5 | 3.81 ± 1.65 |
| Most intervention strategies are inconclusive due to the multitude of risk factors | 20.3 | 2.85 ± 1.74 |
| Insufficient human resources for home rehabilitation | 30.5 | 3.00 ± 1.96 |
| Changing opportunities to practice physical activity | 40.7 | 4.06 ± 1.16 |
| Impossibility of holding group sessions | 61.0 | 3.92 ± 1.78 |
| Modification of the social support network | 40.7 | 3.73 ± 1.50 |
Characterization of facilitators in accessing/obtaining results in physiotherapy during the pandemic
| Facilitators in accessing/obtaining results in physiotherapy | x ± SD | % answers scoring 5 |
|---|---|---|
| Intervention in the natural context of the person with dementia, i.e., home | 3.30 ± 1.47 | 22 |
| Closer relationship between the caregiver and the person with dementia and health professionals (visits and treatment at home; permanent use of telephone contact) | 3.33 ± 1.52 | 22 |
| Families deepened their knowledge about the trajectory of the disease and about the complications that arise in a crisis (e.g., pandemic) | 3.24 ± 1.59 | 22 |
| Enhancement of the caregiver’s ability to decentralize from the act of caring, trusting and delegating their competencies to the reference professionals | 3.22 ± 1.34 | 13.6 |
| Closer relationships between people with dementia and their caregivers | 3.27 ± 1.67 | 23.7 |
| Valuation of going outside by people with dementia | 2.51 ± 1.93 | 16.9 |
| Providing more training and discussion groups for caregivers (online, with no costs, in a more personalized format) | 3.10 ± 1.65 | 22 |
| Alternative ways of dealing with the mental health problem (e.g., more information available; concerns with management of communication using PPE) | 2.71 ± 1.49 | 13.6 |
| Positive experience with previous approaches | 3.24 ± 1.47 | 13.6 |