Working on the Frontlines of the COVID-19 Pandemic: A Qualitative Study of Physical Therapists’ Experience in Spain

Abstract

Objective Knowledge of the experiences of health care professionals who have actively worked on the first line of the COVID-19 pandemic could help in identifying specific professional duties focused on health assistance objectives. No qualitative study has yet been published describing the experience of physical therapists during the COVID-19 pandemic. The purpose of this study was to describe and explore the experiences and perspectives of physical therapists working in public hospitals in Madrid, Spain, during the COVID-19 pandemic. Methods A qualitative exploratory study was conducted based on an interpretive framework. Thirty physical therapists working at 11 national public hospitals during the COVID-19 outbreak were recruited by purposeful sampling and snowball techniques. In-depth interviews and researchers’ field notes were used to collect data. Interviews were transcribed verbatim. Inductive thematic analysis was used to identify emerging themes. Results After identifying 3912 codes and 13 categories, 3 themes emerged. First theme was “Call of Duty,” COVID-19 infection dramatically spread, the hospitals were contaminated and overwhelmed, and all floors were converted into COVID-19 wards. Second theme was “Working in War Time.” Every day, therapists were given “the war report,” receiving their orders, meeting protective personal equipment requirements, and doing a job with fear. Third theme was “When I Arrive at Home.” Working during the pandemic had an impact on the therapists’ families and the information shared with them. Conclusions Physical therapists described the COVID-19 outbreak as an apocalyptic and unexpected war. Comprehensive support is needed for all frontline health care professionals. The COVID-19 outbreak revealed that health care systems were not prepared for a pandemic. Impact This is the first qualitative study to be published describing the experience of physical therapists during the COVID-19 pandemic.

Future Challenges for Physical Therapy during and after the COVID-19 Pandemic: A Qualitative Study on the Experience of Physical Therapists in Spain

“…In Spain, this closure of the rehabilitation services, in addition to the suspension of the treatment, resulted in the use of rehabilitation wards to create new beds for patients with COVID-19, and the redistribution of all physical therapists (PTs) to other units [11][12][13]. This situation resulted in many PTs being integrated into front-line units against COVID-19 such as ICUs without previous training [13,14].…”

“…In Spain, this closure of the rehabilitation services, in addition to the suspension of the treatment, resulted in the use of rehabilitation wards to create new beds for patients with COVID-19, and the redistribution of all physical therapists (PTs) to other units [11][12][13]. This situation resulted in many PTs being integrated into front-line units against COVID-19 such as ICUs without previous training [13,14]. In Spain, there are no recognized physical therapy specialties (i.e., respiratory and/or ICU), therefore, the majority of PTs working at hospital setting belong to the rehabilitation services and are not regularly integrated as part of other units such as ICU, anesthesia, pain management, pneumology, neurology, or traumatology [15].…”

“…Qualitative research helps to describe complex processes which have a great impact on healthcare professionals and healthcare organizations and can help to understand how the COVID-19 pandemic has influenced the perspective, beliefs, and attitudes of PTs [16]. Today, only three qualitative studies have exclusively described the experiences of PTs during the COVID-19 pandemic [13,14,17]. These studies had portrayed the emotional impact of PTs working in front-line units [14], their perspective on the pandemic, their experience upon arriving home [17], and ethical and professional issues that PTs have faced during their assignment to acute COVID-19 units [13].…”

Could Physical Therapy Interventions Be Adopted in the Management of Critically Ill Patients with COVID-19? A Scoping Review

“…During this pandemic, we have observed that acute care and ICUs have become overwhelmed in many countries. In that sense, according to a recent qualitative study performed in Spain, physical therapists have been obligated to help and develop other procedures not directly related to their profession [50], which indirectly hinders the application of these therapies [51]. Therefore, clinicians should consider deeply whether these procedures are indicated in the context of their clinical setting or could be delayed.…”

“…This might be due to several reasons: the saturation of ICUs, the absence of evidence of these procedures in COVID-19 patients, and/or because the risk of virus contagious is very high. Nonetheless, when protective personal equipment and other security requirements are available, we find that it would be very interesting to give more importance to these procedures, given the effectiveness that has been demonstrated [50], which could offer the possibility to reduce the length of stay in ICU survivors [61]. In addition, physical therapy management should be continued after patients are discharged from ICU to reduce ICU-acquired weakness.…”