Patients' and physiotherapists' perspectives on group-based interventions: a mixed systematic review.

Abstract

To identify factors influencing the use, intention to use, satisfaction, attitudes, experience, and preferences regarding group-based interventions in physiotherapy, from the perspectives of patients and physiotherapists. PubMed, Embase, Web of Science, Cochrane, and EBSCO CINAHL databases were searched from inception to September 6, 2024. Included studies used quantitative, qualitative, or mixed-method designs, involved adult patients or physiotherapy professionals, and reported on determinants influencing the use, intention to use, satisfaction, attitudes, experiences, or preferences regarding group-based interventions in physiotherapy. A data-based convergent synthesis approach was adopted. Two independent reviewers extracted data using a data extraction form, treating findings from all studies, regardless of methodological design, as qualitative data. Quantitative results were transformed into textual descriptions to enable integration with qualitative data. All findings were entered into a data matrix and then inductively grouped into common themes. Fifty studies met the inclusion criteria, out of 10,421 identified references. The review identified 32 distinct determinants, which were mapped to nine of the 14 domains of the Theoretical Domains Framework (TDF). Key TDF domains included 'Social influence', 'Environmental context and resources', 'Emotion' and 'Beliefs about capabilities'. Of the included studies, 38 focused on patients, four on physiotherapists, and eight on both groups. Determinants of experience were the most frequently reported. From the patient's perspective, the access to peer support, encouragement, and being among others facing similar challenges, were the most frequently cited determinants of a positive experience, each mentioned in 23 studies. From the physiotherapist's perspective, group size was the most frequently cited determinant of experience, mentioned in four studies, with a suggested optimal size between six and eight participants. These findings can help guide physiotherapy services and policy to better align interventions with the needs and contexts of both groups.