Inclusion of physical therapy services on a short term mobile medical mission team to Nicaragua: a qualitative description study of team members’ observations and recommendations for improvement

Context: Access to physical therapy (PT) services is sorely limited in many developing countries due to the constraints of poverty and regional insufficiency in the number of PT providers. Opportunities exist for physical therapists to participate in short term mobile medical mission (STMMM) efforts to provide PT services in many of those regions. However, there is a relative dearth of research regarding the utility of including PT services in STMMM endeavors. Objective: The aim of this study was to ascertain the impressions and recommendations of medical mission team members regarding the inclusion of PT services during a STMMM trip to underserved areas of Nicaragua. Methods: This was a qualitative description study conducted in 2014. Data were derived from interviews with STMMM participants and analyzed using conventional content analysis as described by Hsieh and Shannon. Results: Emergent themes included evidence of: (1) patient need for and benefit from PT services; (2) team member need for physical therapy services for trip related disorders; and (3) a high prevalence of patient orthopedic disorders related to strenuous activities of daily living. There were also a number of reported limitations in the delivery of PT services including: (1) language barriers; (2) lack of medical provider familiarity with PT capability; and (3) limited means of providing follow-up care. Respondent recommendations included: (1) addition of more translators; (2) inclusion of additional treatment modalities; (3) utilization of Nicaraguan therapists or health care workers to facilitate patient follow-up; and (4) the provision of a comprehensive screening program to improve identification of patients in need of PT services. Conclusion: This study contributes to the understanding of corollaries associated with the addition of PT services to a STMMM and provides recommendations to improve PT services in that context. Additional research is needed to evaluate the soundness of participant responses and whether this information is transferable to STMMM efforts in other communities. Further research is also needed to establish best PT practices in the STMMM context